A key element in controlling the spread of tuberculosis (TB) is treating latent TB infection (also known as sleeping TB) before it becomes an active TB disease. Those with latent TB infection (LTBI) have TB, but it is inactive. They are not sick, and they are not contagious. However, this TB infection could cause a person to become sick with active TB disease without treatment. They could have a cough, fever, poor appetite and weight loss. Those with active TB disease might also be contagious and spread TB to others. This is why it is recommended that those with LTBI take treatment to get rid of the germs before it turns into an active TB disease. If treated, the chance that LTBI will turn into active TB disease in the future is significantly reduced.
This study’s main purpose was to determine whether more people will start and finish treatment for latent TB infection if the treatment is shorter. Usually, people with latent TB infection take one drug, INH. They must take it twice a week for 9 months in Nunavut for a total of 78 doses. In this study, participants would take two drugs, rifapentine and INH, but only once a week for 3 months for a total of 12 doses. The combination of rifapentine and INH is called ‘3HP’. Research studies show that 3HP for 3 months works as well and is as safe as the usual treatment of INH for 9 months.
In this study, we wanted to establish if 3HP was practical and safe in Iqaluit and Qikiqtarjuaq. We did this by conducting a study that included 247 people who were offered 3HP (102 in Iqaluit and 145 in Qikiqtarjuaq). Of the people that started treatment, about 82% of them in Iqaluit and 77% of them in Qikiqtarjuaq completed the treatment. More people completed treatment when compared to the standard therapy of daily doses for nine months. Some people had adverse events while taking this new treatment, but most were mild and did not affect their daily lives. We found that while on treatment, it is better not to drink alcohol or not to take other medications at the same time. The study showed that 3HP is practical and safe for treating LTBI or sleeping TB in Nunavut.
This study has been completed and the results are published in 3 articles:
The latent tuberculosis infection cascade of care in Iqaluit
Cost-effectiveness of 3 months of weekly rifapentine and isoniazid in a Canadian arctic setting
