Reports on HIV/AIDS: 1990

MAY 18, 1990, MMWR, Vol. 39, RR-8: [inclusive page numbers]
Patients should be thoroughly educated and should be monitored monthly, in
person, by appropriately trained personnel. Isoniazid preventive therapy should not
be prescribed if monthly monitoring cannot be done. Some data indicate that black
and Hispanic women, especially postpartum, may be at greater risk of serious or fatal
adverse reactions and, therefore, should be closely monitored (14-16). Reducing the
risk of adverse reactions, even when this risk is low, is as important as providing the
benefits of preventive therapy. Additional details on preventive therapy have been
published (9).
References
1. CDC. A strategic plan for the elimination of tuberculosis in the United States. MMWR
1989;38(suppl no. S-3):1-25.
2. Comstock GW, Woolpert SF. Preventive therapy. In: Kubica GP, Wayne LG, eds. The
mycobacteria: a sourcebook. New York: Marcel Dekker, Inc, 1984:1071-82.
3. International Union Against Tuberculosis Committee on Prophylaxis. Efficacy of various
durations of isoniazid preventive therapy for tuberculosis: five years of follow-up in the IUAT
trial. Bull WHO 1982;60:555-64.
4. Hsu KH. Thirty years after isoniazid: its impact on tuberculosis in children and adolescents.
JAMA 1984;251:1283-5.
5. Stead WW, To T, Harrison RW, Abraham JH. Benefit-risk considerations in preventive
treatment for tuberculosis in elderly persons. Ann Intern Med 1987;107:843-5.
6. Comstock GW, Baum C, Snider DE. Isoniazid prophylaxis among Alaskan Eskimos: a final
report of the Bethel isoniazid studies. Am Rev Respir Dis 1979;119:827-30.
7. Rose DN, Schecter CB, Fahs MC, Silver AL. Tuberculosis prevention: cost-effectiveness
analysis of isoniazid chemoprophylaxis. Am J Prev Med 1988;4:102-9.
8. Glassroth JB, Hopewell PC, Bailey WC, Harden J. Why tuberculosis is not prevented. Am Rev
Respir Dis (in press).
9. American Thoracic Society/CDC. Treatment of tuberculosis and tuberculosis infection in
adults and children. Am Rev Respir Dis 1986;134:355-63.
10. American Thoracic Society/CDC. Diagnostic standards and classification of tuberculosis. Am
Rev Respir Dis (in press).
11. Narain R, Chandrasekhar P, Naganna K. A fresh look at the definition of tuberculous infection
and new infection. Ind J Med Res 1976;64:336-57.
12. Stead WW, To T. The significance of the tuberculin skin test in elderly persons. Ann Intern
Med 1987;107:837-42.
13. Bass JB, Sanders RV, Kirkpatrick MB. Choosing an appropriate cutting point for conversion
in annual tuberculin skin testing. Am Rev Respir Dis 1985;132:379-81.
14. Kopanoff DE, Snider DE, Caras GJ. Isoniazid related hepatitis. Am Rev Respir Dis 1978;
117:991-1001.
15. Franks AL, Binkin NJ, Snider DE, Rokaw WM, Becker S. Isoniazid hepatitis among pregnant
and postpartum Hispanic patients. Public Health Rep 1989;104:151-5.
16. Moulding TS, Redeker AG, Kanel GC. Twenty isoniazid-associated deaths in one state. Am
Rev Respir Dis 1989;140:700-5.

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