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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