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Impact of TB Preventive Therapy for HIV/TB Co-infected Patients with Access to Highly Active Antiretroviral Therapy in Rio de Janeiro, Brazil: A Phased Implementation Trial. A project of Consortium to Respond Effectively to the AIDS-TB Epidemic (CREATE)


The THRio study is designed to determine whether the routine detection and treatment of TB infection found in HIV infected patients in HIV clinics in Rio de Janeiro, Brazil, reduces TB incidence in the clinic population receiving HIV care. Involving an estimated 15,000 clinic patients, the intervention consists of implementing a comprehensive policy of screening for and treating latent TB infection in all HIV-infected patients. The trial takes a phased-implementation approach to ensure that all participating clinics eventually have full coverage. Phased implementation is a realistic and pragmatic method to effectively train all clinic personnel in the skills required to appropriately test and treat these patients. Brazil was the ideal location for this study because the government has made antiretroviral (ARV) therapy freely available for years. Although it is already known that treatment with ARV therapy reduces the risk of developing tuberculosis at the individual level, this study will inform us about additional protection afforded by TB preventive therapy in a population with free access to ARV therapy. The expected reduction in TB incidence is 60%, translating to 1,670 prevented cases of TB per 100,000 population per year.


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