***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 OBJECTIVES To determine the rate of and risk factors for discontinuation of isoniazid due to adverse effects during the treatment of latent tuberculosis infection in a large , multi-site study . METHODS The Tuberculosis Epidemiologic Studies Consortium ( TBESC ) conducted a prospect i ve study from March 2007-September 2008 among adults initiating isoniazid for treatment of LTBI at 12 sites in the US and Canada . The relative risk for isoniazid discontinuation due to adverse effects was determined using negative binomial regression . Adjusted models were constructed using forward stepwise regression . RESULTS Of 1306 persons initiating isoniazid  , 617 ( 47.2 % , 95 % CI 44.5 - 50.0 % ) completed treatment and 196 ( 15.0 % , 95 % CI 13.1 - 17.1 % ) discontinued due to adverse effects . In multivariable analysis , female sex ( RR 1.67 , 95 % CI 1.32 - 2.10 , p < 0.001 ) and current alcohol use ( RR 1.41 , 95 % CI 1.13 - 1.77 , p = 0.003 ) were independently associated with isoniazid discontinuation due to adverse effects . CONCLUSIONS The rate of discontinuation of isoniazid  due to adverse effects was substantially higher than reported earlier . Women were at increased risk of discontinuing isoniazid due to adverse effects ; close monitoring of women for adverse effects may be warranted . Current alcohol use was also associated with isoniazid discontinuation ; counseling patients to abstain from alcohol could decrease discontinuation due to adverse effects Background . Treatment of latent tuberculosis infection with isoniazid ( INH ) or rifampin ( RIF ) is controversial in liver transplant c and i date s due to potential hepatotoxicity . In this study , treatment of latent tuberculosis during transplant c and idacy period is explored , and relevant literature is review ed . Methods . Liver transplant c and i date s with latent tuberculosis infection by positive tuberculin skin test ( > 5 mm ) were prospect ively enrolled and treated with 9 months of INH or 4 months of RIF , and were monitored monthly for their liver enzyme profiles , adverse effects , compliance , and completion rate . Results . Four of nine patients with INH had asymptomatic , mild elevations of aspartate aminotransferase ( AST ) or alanine aminotransferase ( ALT ) versus none of five patients in the RIF group . Two cases of elevations were attributed to INH . Two other cases were attributed to alcoholism or active chronic hepatitis B virus infection . Only one patient in the INH group experienced symptoms possibly attributed to INH hepatotoxicity . Compliance was 100 % per patient reporting . Completion rates were 79 % for INH and 100 % for RIF . No fulminant hepatic failure or death was observed . Conclusion . Treatment of latent tuberculosis in liver transplant patients during their c and idacy with INH or RIF appears to be a safe , viable option , if carefully monitored for adverse effects and liver enzymes 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 Previous studies have demonstrated the efficacy of treatment for latent tuberculosis infection ( TLTBI ) in persons infected with the human immunodeficiency virus , but few studies have investigated the operational aspects of implementing TLTBI in the co-infected population .The study objectives were to describe eligibility for TLTBI as well as treatment prescription , initiation and completion in an HIV-infected Spanish cohort and to investigate factors associated with treatment completion . Methods Subjects were prospect ively identified between 2000 and 2003 at ten HIV hospital-based clinics in Spain . Data were obtained from clinical records . Associations were measured using the odds ratio ( OR ) and its 95 % confidence interval ( 95 % CI ) . Results A total of 1242 subjects were recruited and 846 ( 68.1 % ) were evaluated for TLTBI . Of these , 181 ( 21.4 % ) were eligible for TLTBI either because they were tuberculin skin test ( TST ) positive ( 121 ) or because their TST was negative/unknown but they were known contacts of a TB case or had impaired immunity ( 60 ) . Of the patients eligible for TLTBI , 122 ( 67.4 % ) initiated TLTBI : 99 ( 81.1 % ) were treated with isoniazid for 6 , 9 or 12 months ; and 23 ( 18.9 % ) with short-course regimens including rifampin plus isoniazid and /or pyrazinamide . In total , 70 patients ( 57.4 % ) completed treatment , 39 ( 32.0 % ) defaulted , 7 ( 5.7 % ) interrupted treatment due to adverse effects , 2 developed TB , 2 died , and 2 moved away . Treatment completion was associated with having acquired HIV infection through heterosexual sex as compared to intravenous drug use ( OR:4.6 ; 95 % CI:1.4 - 14.7 ) and with having taken rifampin and pyrazinamide for 2 months as compared to isoniazid for 9 months ( OR:8.3 ; 95 % CI:2.7 - 24.9 ) . Conclusions A minority of HIV-infected patients eligible for TLTBI actually starts and completes a course of treatment . Obstacles to successful implementation of this intervention need to be addressed 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 Treatment of latent Mycobacterium tuberculosis infection with isoniazid can cause hepatotoxicity , but the risk of isoniazid-associated hepatotoxicity among persons coinfected with hepatitis C virus ( HCV ) is unknown . We conducted a prospect i ve study among 146 injection drug users with M. tuberculosis infection and normal baseline hepatic transaminase values who were treated with isoniazid .  Of 146 participants , 138 ( 95 
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Although inconsistent event reporting and high heterogeneity limited comparisons , the adverse event profile of INH/RPT-3 appeared generally favorable .
Flu-like reactions were reported with an increased frequency and hepatotoxicity with a lower frequency than st and ard treatment .