Abstract
Background: South Africa is the epicentre of the HIV pandemic, and this has contributed to the high rise of tuberculosis (TB) cases in the country. The use of isoniazid preventive therapy (IPT) is essential in the reduction of mortality and morbidity related to TB among people living with HIV (PLHIV).
Objective: To determine the effectiveness of IPT in preventing TB among PLHIV in Lyttleton clinic, Centurion, South Africa.
Method: This study followed a retrospective descriptive cohort design. The study population consisted of 3,660 adults living with HIV/AIDS who attended Lyttelton Clinic, Centurion, South Africa. This study used secondary data from patient medical records and the Tier.Net database for patients enrolled in the TB-HIV Integrated Project between January 2018 and April 2024. A data abstraction tool was developed and utilised for extracting the variables of interest, including demographic factors, PLHIV on ART, on IPT, and related health outcomes. The study was approved by the University of Johannesburg Research Ethics Committee (241112-035). Descriptive statistics were employed to describe patient characteristics using frequency and percentages. All data were analysed using the Statistical Package for Social Sciences (SPSS) version 29. Significance was considered at p<0.05.
Results: The study comprised 82% females, 18% males, while 2.5% of participants were adolescents aged 10–14 years. Furthermore, IPT completion rate was 95.0%. Chi-square showed statistically significant associations were observed between having received IPT and TB Positive status (p = 0.000), PLHIV Completed IPT (p = 0.000), PLHIV interrupted IPT (p = 0.000), CD4 count (p = 0.000), VL (p = 0.000), infected by TB infections before receiving IPT (p = 0.000), PLHIV who never received IPT due to contraindication (p = 0.000), and PLHIV who adjusted to TB after IPT (p = 0.042).
Conclusion: The study showed that IPT uptake among PLHIV was very high, with a completion rate of 95.0%. Only 5.0% interrupted treatment, 2.0% discontinued due to side effects, and 2.0% did not start due to contraindications. Moreover, only 1.0% of the population developed TB after receiving IPT, confirming the protective benefits of preventive therapy. Future programmatic improvements to support IPT should incorporate screening, recommend short-course treatment, and improve interventions for men and adolescent populations.