Isoniazid preventive therapy in HIV-infected pregnant and postpartum women
New England Journal of Medicine Oct 09, 2019
Gupta A, Montepiedra G, Aaron L, et al. - Via a multicenter, double-blind, placebo-controlled, noninferiority trial, researchers randomized pregnant women with HIV infection who are receiving antiretroviral therapy, to receive isoniazid preventive therapy for 28 weeks, started either during pregnancy (immediate group) or at week 12 following delivery (deferred group) in order to ascertain safety, efficiency, and relevant timing of isoniazid therapy to counter tuberculosis in such woman. A total of 956 women were recruited. Six women acquired tuberculosis. A greater incidence of an event incorporated in the composite adverse pregnancy outcome (stillbirth or spontaneous abortion, low birth weight in an infant, preterm delivery, or congenital anomalies in an infant) was noted in the immediate group vs the deferred group. Thus, in comparison with those related to the beginning of therapy during the postpartum period, the risks correlated with the beginning of isoniazid preventive therapy during pregnancy seemed to be greater.
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