TB Manual

3.4.1. Rifapentine and isoniazid daily for one month (1HP)

The 1HP regimen given daily has been shown to be noninferior to self-administered 9H in a large RCT in HIV patients in Africa.⁵⁰ The applicability of this regimen in low-burden settings is still unknown, given that the regimen was provided to participants regardless of results from the tuberculin skin test or interferon-gamma release assay (although in a subgroup analysis in patients with confirmed LTBI, 1HP was noninferior to 9H). To date, there have been no studies published looking at this regimen in the HIV-negative population, although a clinical trial is ongoing.⁵¹ Nonetheless, the WHO has recommended this regimen regardless of HIV status.²

Good practice statement

• Until further evidence is published in patients without human immunodeficiency virus who have confirmed latent TB infection in low TB-burden settings, isoniazid daily for 1 month (1HP) should not be used for tuberculosis preventive treatment in Canada.

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