Comparative analysis of TB preventive therapy efficacies in HIV patients

Latent Tuberculosis Infection (LTBI) is associated with increased immune activation and a heightened risk of cardiovascular diseases. The ACTG A5279 trial, a phase 3 study presented at the Conference on Retroviruses and Opportunistic Infections (CROI), investigated the activation patterns of monocytes in individuals with HIV (PWH). This trial compared the efficacy of 4 weeks of daily rifapentine (RFP) and isoniazid (INH) against 9 months of daily INH for Tuberculosis Preventive Therapy (TPT). At baseline and week 48, PWH with LTBI, compared to those with negative TST/IGRA results, demonstrated changes in monocytes indicative of ongoing activation and tissue migration.