Assessment for Antibodies to Rifapentine and Isoniazid in Persons Developing Flu-Like Reactions During Treatment of Latent Tuberculosis Infection

Details

• Alternative Title:
  J Infect Dis
• Personal Author:
  Moro, Ruth N. ; Mehaffy, Carolina ; De, Prithwiraj ; Phillips, Elizabeth ; Borisov, Andrey S. ; Sterling, Timothy R. ; Dobos, Karen M.
• Description:
  Background. ; Flu-like reactions can occur after exposure to rifampin, rifapentine, or isoniazid. Prior studies have reported the presence of antibodies to rifampin, but associations with underlying pathogenesis are unclear. ; Methods. ; We evaluated PREVENT TB study participants who received weekly isoniazid plus rifapentine for 3 months (3HP) or daily isoniazid for 9 months (9H) as treatment for Mycobacterium tuberculosis infection. Flu-like reaction was defined as a grade ≥2 of any of flu-like symptoms. Controls (3HP or 9H) did not report flu-like reactions. We developed a competitive enzyme-linked immunosorbent assays (ELISA) to detect antibodies against rifapentine, isoniazid, rifampin, and rifapentine metabolite. ; Results. ; Among 128 participants, 69 received 3HP (22 with flu-like reactions; 47 controls) and 59 received 9H (12 with flu-like reactions; 47 controls). In participants receiving 3HP, anti-rifapentine IgG was identified in 2 of 22 (9%) participants with flu-like reactions and 6 of 47 (13%) controls (P = .7), anti-isoniazid IgG in 2 of 22 (9%) participants with flu-like reactions and 4 of 47 (9%) controls (P = .9). Among participants receiving 9H, IgG and IgM anti-isoniazid antibodies were each present in 4 of 47 (9%) controls, but none among participants with flu-like reactions; anti-rifapentine IgG antibodies were not present in any participants with flu-like reactions or controls. ; Conclusions. ; We detected anti-rifapentine, anti-isoniazid, and anti-rifapentine metabolite antibodies, but the proportions of participants with antibodies were low, and did not differ between participants with flu-like reactions and those without such reactions. This suggests that flu-like reactions associated with 3HP and 9H were not antibody mediated. ; Clinical Trials Registration. ; NCT00023452.
• Subjects:
  • Adolescent
  • Adult
  • Aged
  • Antibodies
  • Antitubercular Agents
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Influenza, Human
  • Isoniazid
  More +
• Keywords:
  • rifapentine
  • isoniazid
  • antibodies
  • latent tuberculosis
  • M. tuberculosis
• Source:
  J Infect Dis. 230(5):1271-1278
• Pubmed ID:
  38640958
• Pubmed Central ID:
  PMC11489317
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Volume:
  230
• Issue:
  5
• Download URL:
  https://stacks.cdc.gov/view/cdc/166694/cdc_166694_DS1.pdf
• File Type:
  [PDF - 527.64 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:b981940c95a55a03a8fc9a50c35fff7018075796da5cd7b0944a11b576fd24ab2960744e78c5d54827888cad5b5f2ddb9d01425e4b22579252e17a082a61ffaa