Treatment to prevent tuberculosis (TB) and other lung diseases in HIV-infected miners in South Africa has only limited efficacy, according to a study presented at the Fourteenth International AIDS Conference.
Dr Alison Grant of the London School of Hygiene and Tropical Medicine told the conference that 1,921 HIV-infected miners attended a prevention clinic set up to protect the health of the HIV-infected workers. Approximately 70% of the HIV-infected miners were treated with isoniazid to prevent TB and 28% received cotrimoxazole to prevent a range of infections including pneumonia.
After two years, the incidence of tuberculosis was reduced by 34% but the overall rate of cotrimoxazole-preventable infections fell by only 13%. Only in men aged over 40 years was there a significant reduction in the incidence of cotrimoxazole-preventable infections.
Dr Grant told the conference that high rates of silicosis among miners in this study may have contributed to the disappointing results. She said the study prompts consideration of therapies which target particular infections, as well as antiretroviral therapies, to further reduce the rates of opportunistic infections among HIV-infected workers in South Africa.
Grant, AD et al. Effectiveness of primary prophylaxis regimes among HIV-infected employees in South Africa. Fourteenth International AIDS Conference, Barcelona, abstract MoOrB1006, 2002.