TB preventive therapy: a new era is emerging
Abstract: TB infection is the reservoir of the TB epidemic. The burden of TB infection has recently been re-estimated at approximately 23%, amounting to approximately 1.7 billion people infected with TB globally. The uptake of isoniazid preventive therapy globally among people living with HIV and household contacts has been very poor. Recently published randomised clinical trials show that TB preventive therapy with antiretroviral therapy saves lives. Furthermore, recently completed clinical trials provide evidence for novel, short and ultra-short course, rifamycin based TB preventive therapy regimens. The World Health Organisation has recently issued integrated guidance for the programmatic management of latent TB infection, which recommends short-course regimens such as high-dose isoniazid and rifapentine weekly for 12 weeks in high-burden countries. Interventions to address market and public health barriers to the scale up of TB preventive therapy, particularly rifapentine based regimens, will be discussed. Opportunities for further innovation in TB preventive therapy will be presented.
Bio: Prof Churchyard is the founder and Group Chief Executive Officer of the Aurum Institute, an independent, not for profit, proudly South African, public benefit organization that focuses on TB and HIV health system strengthening, implementation and research in South Africa and 21 other high-burden countries. Prof Churchyard is a specialist physician, internationally renowned for his research in tuberculosis (TB) and HIV. Prof Churchyard was the Chair of the World Health Organization Task Force for new TB drugs and regimens and serves on many other WHO expert committees. Prof Churchyard is a member of the Lancet Commission on TB that seeks to inform the United Nations General Assembly special meeting on TB in September 2018. Prof Churchyard plays an international leadership role in TB research and is the Chair of the AIDS Clinical Trials Group (ACTG) Transformative Science Group for TB, and is the co-Chair of the TB Vaccine working group in the HIV Vaccine Trials Network (HVTN). Prof Churchyard has published more than 240 publications on TB and HIV.