Urine metabolite-determined isoniazid adherence under programmatic conditions in people living with HIV.

IF 3.4 3区医学 Q2 INFECTIOUS DISEASES

International Journal of Tuberculosis and Lung Disease Pub Date : 2025-03-01 DOI:10.5588/ijtld.24.0406

S A Nabity, A D Moffitt, K Mponda, M Melgar, S B Zimba, D Surie, R E Marshall, R Nyirenda, B Girma, T F Mekonnen, A Maida, A F Auld, L J Gunde, A S Muula, S Gutreuter, J E Oeltmann

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Abstract

BACKGROUNDChemotherapy to prevent TB is a core component of care for persons living with HIV (PLHIV). There are few reports describing adherence to TB prevention under programmatic conditions in high TB burden settings.METHODSWe measured adherence to daily isoniazid (INH) preventive treatment (IPT) using a commercially available colourimetric assay to detect urine INH metabolites among PLHIV who self-reported INH ingestion within the preceding 24 h. Enrollee characteristics associated with non-adherence despite self-reported INH ingestion were identified in multivariate log-binomial regression. Interoperator reliability for the detection of INH metabolites was calculated among three independent operators.RESULTSSelf-reported INH ingestion and metabolite data were known for 300 PLHIV. INH metabolite was detected in 112 (68.7%) of 163 PLHIV who self-reported INH ingestion in the preceding 24 h. The prevalence of alcohol consumption was significantly higher among INH-non-adherent PLHIV compared with INH-adherent PLHIV (adjusted prevalence ratio 2.43, 95% CI 1.16-5.12). Two-way interoperator reliability ranged from κ 0.86 to κ 0.94.CONCLUSIONSCompared with self-reported 24-h INH ingestion in a high TB-HIV-incidence programmatic setting, biometric adherence to IPT was suboptimal in this sample of PLHIV. Alcohol consumption was the only potentially modifiable risk factor significantly associated with INH non-adherence. Colourimetric interpretation reliability across three operators was moderate/strong..

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艾滋病毒感染者在规划条件下尿代谢物测定异烟肼依从性。

背景：预防结核病的化疗是艾滋病毒感染者护理的核心组成部分。在结核病高负担环境中，很少有报告描述在规划条件下坚持结核病预防的情况。方法：我们使用市售比色法检测24小时内自报摄入异烟肼（INH）的PLHIV患者尿液中INH代谢物，以测量每日异烟肼（INH）预防治疗（IPT）的依从性。通过多变量对数二项回归确定了尽管自报摄入INH但未坚持治疗的入组者特征。在三个独立的操作符之间计算INH代谢物检测的操作符间可靠性。结果300例PLHIV患者自报的INH摄取量和代谢物数据是已知的。163名自我报告在24小时前摄入INH的PLHIV中，有112名（68.7%）检测到INH代谢物。与INH-依从性PLHIV相比，INH-非依从性PLHIV的饮酒患病率显著高于INH-依从性PLHIV（校正患病率为2.43,95% CI为1.16-5.12）。双向互操作信度范围为κ 0.86 ~ κ 0.94。结论：与tb - hiv高发病率规划环境中自我报告的24小时INH摄取量相比，该PLHIV样本中IPT的生物计量依从性并不理想。饮酒是唯一与INH不依从性显著相关的潜在可改变的危险因素。三家运营商的比色解释可靠性为中等/强。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Tuberculosis and Lung Disease 医学-传染病学

CiteScore

4.90

自引率

20.00%

发文量

266

审稿时长

2 months

期刊介绍： The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.