***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare the adverse effects and treatment adherence between 2 months of rifampin plus pyrazinamide ( 2RZ ) and 6 months of isoniazid ( 6H ) . BACKGROUND Patients with silicosis in Hong Kong are at high risk of acquiring tuberculosis . A previous study showed that treatment with 6H reduced the risk of silico-tuberculosis by one half . METHOD Patients with silicosis and a Mantoux skin test reaction > or = 10 mm were r and omized to receive either 2RZ or 6H daily .  Liver function testing was done monthly during the initial 2 months . The adverse effects and treatment adherence were compared between the two regimens . RESULTS Forty patients ( mean age , 61.6 + /- 9.1 years ) and 36 patients ( mean age , 57.6 + /- 9.7 years ) were r and omized to the 2RZ and 6H arms , respectively ( p > 0.05 ) [ + /- SD ] . Baseline characteristics were comparable . Nineteen patients in the 2RZ arm had peak alanine transaminase ( ALT ) levels > 1.5 times the upper limit of normal ( ULN ) in comparison with only five study subjects of the 6H arm ( 47.5 % vs 13.9 % , p < 0.01 ) . Fourteen patients ( 35 % ) in the 2RZ arm and 1 patient ( 2.8 % ) in the 6H arm had peak ALT levels more than five times the ULN ( p < 0.001 ) . Only seven patients had symptoms suggestive of hepatitis ; none of the patients had jaundice . All recovered after withholding treatment . In the 2RZ study arm , none of the baseline characteristics predicted hepatotoxicity . Other adverse effects were generally mild and comparable between both study arms . Treatment was stopped prematurely in 45 % and 36.1 % of patients in the 2RZ and 6H arms , respectively ( p = 0.43 ) . The main reasons were hepatotoxicity for the 2RZ arm and voluntary withdrawal after experiencing other minor adverse effects for the 6H arm . CONCLUSION A higher incidence of hepatotoxicity was associated with rifampin plus pyrazinamide than isoniazid in the treatment of latent tuberculosis infection among patients with silicosis in Hong Kong Background With the renewed emphasis to implement isoniazid preventive therapy ( IPT ) in Sub-Saharan Africa , we investigated the effect of IPT on immunological profiles among household contacts with latent tuberculosis . Methods Household contacts of confirmed tuberculosis patients were tested for latent tuberculosis using the QuantiFERON ® -TB Gold In-Tube ( QFN ) assay and tuberculin skin test ( TST ) . HIV negative contacts aged above 5 years , positive to both QFN and TST , were r and omly assigned to IPT  and monthly visits  or monthly visits only . QFN culture supernatants from enrolment and six months ’ follow-up were analysed for M.tb-specific Th1 , Th2 , Th17 , and regulatory cytokines by Luminex assay , and for M.tb-specific IgG antibody concentrations by ELISA . Effects of IPT were assessed as the net cytokine and antibody production at the end of six months . Results Sixteen percent of contacts investigated ( 47/291 ) were r and omised to IPT ( n = 24 ) or no IPT ( n = 23 ) . After adjusting for baseline cytokine or antibody responses , and for presence of a BCG scar , IPT ( compared to no IPT ) result ed in a relative decline in M.tb-specific production of IFN gamma ( adjusted mean difference at the end of six months ( bootstrap 95 % confidence interval ( CI ) , p-value ) -1488.6 pg/ml ( ( −2682.5 , −294.8 ) , p = 0.01 ) , and IL- 2 ( −213.1 pg/ml ( −419.2 , −7.0 ) , p = 0.04 ) . A similar decline was found in anti-CFP-10 antibody levels ( adjusted geometric mean ratio ( bootstrap 95 % CI ) , p-value ) 0.58 ( ( 0.35 , 0.98 ) , p = 0.04 ) . We found no effect on M.tb-specific Th2 or regulatory or Th17 cytokine responses , or on antibody concentrations to PPD and ESAT-6 . Conclusions IPT led to a decrease in Th1 cytokine production , and also in the anti CFP-10 antibody concentration . This could be secondary to a reduction in mycobacterial burden or as a possible direct effect of isoniazid induced T cell apoptosis , and may have implication s for protective immunity following IPT in tuberculosis-endemic countries . Trial registration IS RCT N registry , IS RCT N15705625 . Registered on 30th September 2015 Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND Tuberculosis is epidemic among workers in South African gold mines . We evaluated an intervention to interrupt tuberculosis transmission by means of mass screening that was linked to treatment for active disease or latent infection . METHODS In a cluster-r and omized study , we design ated 15 clusters with 78,744 miners as either intervention clusters ( 40,981 miners in 8 clusters ) or control clusters ( 37,763 miners in 7 clusters ) . In the intervention clusters , all miners were offered tuberculosis screening . If active tuberculosis was diagnosed , they were referred for treatment ; if not , they were offered 9 months of isoniazid preventive therapy . The primary outcome was the cluster-level incidence of tuberculosis during the 12 months after the intervention ended . Secondary outcomes included tuberculosis prevalence at study completion . RESULTS In the intervention clusters , 27,126 miners ( 66.2 % ) underwent screening . Of these miners , 23,659 ( 87.2 % ) started taking isoniazid , and isoniazid was dispensed for 6 months or more to 35 to 79 % of miners , depending on the cluster . The intervention did not reduce the incidence of tuberculosis , with rates of 3.02 per 100 person-years in the intervention clusters and 2.95 per 100 person-years in the control clusters ( rate ratio in the intervention clusters , 1.00 ; 95 % confidence interval [ CI ] , 0.75 to 1.34 ; P=0.98 ; adjusted rate ratio , 0.96 ; 95 % CI , 0.76 to 1.21 ; P=0.71 ) , or the prevalence of tuberculosis ( 2.35 % vs. 2.14 % ; adjusted prevalence ratio , 0.98 ; 95 % CI , 0.65 to 1.48 ; P=0.90 ) . Analysis of the direct effect of isoniazid in 10,909 miners showed a reduced incidence of tuberculosis during treatment ( 1.10 cases per 100 person-years among miners receiving isoniazid vs. 2.91 cases per 100 person-years among controls ; adjusted rate ratio , 0.42 ; 95 % CI , 0.20 to 0.88 ; P=0.03 ) , but there was a subsequent rapid loss of protection . CONCLUSIONS Mass screening and treatment for latent tuberculosis had no significant effect on tuberculosis control in South African gold mines , despite the successful use of isoniazid in preventing tuberculosis during treatment . ( Funded by the Consortium to Respond Effectively to the AIDS TB Epidemic and others ; Thibela TB Current Controlled Trials number , IS RCT N63327174 . ) BACKGROUND A 9-month course of isoniazid monotherapy is currently recommended for the treatment of latent tuberculosis infection ( LTBI ) and has been shown to be effective in both children and adults . Reduced compliance with this regimen has forced physicians to explore shorter regimens . The aim of this study was to compare 3- and 4-month combination regimens of isoniazid plus rifampin with a 9-month regimen of isoniazid monotherapy for the treatment of LTBI in children . METHODS This prospect i ve , r and omized , controlled study was conducted over an 11-year period ( 1995 - 2005 ) . In period 1 ( 1995 - 1998 ) , 232 patients received isoniazid therapy for 9 months ( group A ) , and 238 patients received isoniazid and rifampin for 4 months ( group B ) . In period 2 ( 1999 - 2002 ) , 236 patients were treated with isoniazid and rifampin for 4 months ( group C ) , and 220 patients received the same regimen for 3 months ( group D ) . All patients were observed for > or = 3 years . RESULTS Overall compliance with treatment was good , but patients who received isoniazid monotherapy were less compliant than were those who received short-course combination therapy ( P=.011 , for group A vs. group B ; P=.510 , for group C vs. group D ) . No patient in any group developed clinical disease during the follow-up period . New radiographic findings suggestive of possible active disease were more common in patients who received isoniazid monotherapy ( 24 % ) than in those treated with shorter regimens ( 11.8 % , 13.6 % , and 11 % for groups B , C , and D , respectively ; P=.001 for group A vs. group B ; P=.418 for group C vs. group D ) . Serious drug-related adverse effects were not detected . CONCLUSIONS Short-course treatment with isoniazid and rifampin for 3 - 4 months is safe and seems to be superior to a 9-month course of isoniazid monotherapy INTRODUCTION The aim of this study was to compare the adherence to , and side effects of a 3-month short-course treatment for latent tuberculosis infection as compared to the st and ard 6-month course . METHODS Prospect i ve , comparative , r and omized , open trial including patients with a positive tuberculin skin test and appropriate criteria for treatment in accordance with the CDC guidelines , and excluding patients with HIV infection . Group I ( 6H ) was assigned to isoniazid 300 mg per day for 6 months and Group II ( 3HR ) was assigned to isoniazid 300 mg per day plus rifampin 600 mg per day for 3 months . The patients were followed up for five years . RESULTS A total of 105 patients were included , among which 9 refused treatment ; 45 patients were placed in Group I and 51 patients in Group II . Both groups were comparable at baseline . Hepatotoxicity was 44 % in Group 6H and 29 % in Group 3HR ( P = 0.07 ) . Hepatotoxicity was severe in 6.7 % of Group 6H and 5.8 % of Group 3HR , requiring treatment interruption in 4.4 % and 1.9 % , respectively ( P = NS ) . Among the total , 75.6 % of patients in group 6H , and 90.2 % in group 3HR completed the study treatment ( P = 0.05 ) . Tuberculous disease was detected in only one patient in the 6H group , occurring in the second month of treatment . CONCLUSION In the treatment of latent tuberculosis infection , a 3-month course of isoniazid plus rifampin result ed in better adherence and a lower percentage of discontinued treatments than a 6-month isoniazid course . Tolerance was similar in the two regimens SETTING Nine public health care centres in four Spanish cities . OBJECTIVE To evaluate the efficacy and safety of 2 months of rifampicin ( R ) plus pyrazinamide ( Z ) therapy ( 2RZ ) compared with a 6-month course of isoniazid therapy ( 6H ) for treating latent tuberculosis infection ( LTBI ) . DESIGN Multicentered , r and omised , comparative and prospect i ve trial conducted in HIV-seronegative contacts of infectious pulmonary TB cases . RESULTS Of 352 individuals , 199 received 6H and 153 2RZ ; 73 % of contacts receiving 6H and 71 % receiving 2RZ completed treatment ( P = 0.73 ) . Treatment interruption due to hepatotoxicity ( ALT/AST > 5 times upper limit of normal ) was observed in 10 % of contacts in the 2RZ group and in 2.5 % of the 6H group ( P = 0.007 ) . This higher than expected rate of hepatotoxicity in the 2RZ arm led to premature termination of the study . Severe or fatal liver injury was not detected . Liver function tests normalised after discontinuation of treatment . We conclude that the use of RZ should only be considered when other regimens are unsuitable and intensive monitoring of liver function is feasible There is little published information regarding treatment completion , safety , and efficacy of rifampin administered daily for 4 months-a recommended alternative to 9 months of isoniazid for therapy of latent tuberculosis infection . In an open-label r and om 
    Output:
    
All regimens of interest except INH-9 showed significant benefits in preventing active TB compared to placebo .
Comparisons between active regimens did not reveal significant differences .
While definitions of regimen completion varied across studies , regimens of 3–4 months were associated with a greater likelihood of adequate completion .
Conclusions Most of the active regimens showed an ability to reduce the risk of active TB relative to no treatment , however important differences between active regimens were not found .
Shorter rifamycin-based regimens may offer comparable benefits to longer INH regimens .
Regimens of 3–4 months duration are more likely to be completed than longer regimens