The Centers for Disease Control and Prevention (CDC) has updated its recommendation for once-weekly isoniazid-rifapentine for 12 weeks (3HP) for the treatment of latent tuberculosis (TB) infection, which has now been published in the Morbidity and Mortality Weekly Report.

Short-course combination regimens of once-weekly isoniazid-rifapentine for 12 weeks (3HP) for the treatment of latent TB infection (LTBI) in adults continue to be recommended. With regard to age limits, HIV infection, and administration of the treatment, the CDC now also recommends the following:

  • the use of 3HP in children/adolescents aged 2 to 17 years with LTBI;
  • the use of 3HP in persons with LTBI who are living with HIV infection, including those who have AIDS and are currently receiving antiretroviral medications that have acceptable drug-drug interactions with rifapentine; and
  • the use of 3HP by directly observed therapy (DOT) or self-administered therapy (SAT) in individuals aged 2 years and older: the healthcare provider should select the most optimal mode of administration (DOT vs SAT) on the basis of local practice, individual patient attributes and preferences, and other considerations, including risk for progression to more severe forms of the disease.

The authors note that in case of a possible severe adverse reaction, 3HP should be stopped and supportive medical care administered. “Conservative management and continuation of 3HP under observation can be considered in the presence of mild to moderate adverse events as determined by health care provider,” they conclude.

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Borisov AS, Bamrah Morris S, Njie GJ, et al. Update of recommendations for use of once-weekly isoniazid-rifapentine regimen to treat latent Mycobacterium tuberculosis infection. Morb Mortal Wkly Rep. 2018;67(25):723-726.