Tuberculosis prevention for high-risk groups (IMPAACT4TB)

TB has severely affected children in communities worldwide, especially in sub-Saharan Africa. One million children (0–14 years of age) fell ill with TB, and 230,000 children (including children with HIV associated TB) died from the disease in 2017. IMPAACT4TB will help to scale an effective intervention to prevent tuberculosis for 400,000 people living with HIV/AIDS and for children (Image: Shezad Noorani)

People living with HIV and children are at increased risk of progressing from latent to active TB

Challenges

Latent TB infection is the reservoir of the TB epidemic. Worldwide, an estimated 1.7 billion people are infected.

Solutions

The IMPAACT4TB project will provide access to three-month-long preventive therapy known as 3HP for people living with HIV, and children under five years old. The project seeks to establish 3HP as an affordable, quality-assured, less-toxic therapy suitable for wide introduction in countries most affected by TB.

“TB infection is the reservoir from which active TB cases develop, which in turn fuels ongoing TB transmission. Scaling up new, safer, shorter TB preventive therapy regimens is essential to contain the reservoir of TB infection and to accelerate progress to ending the TB epidemic.”

Prof Gavin Churchyard, Group CEO, The Aurum Institute.

Progress so far

The project started in September 2017 with a pharmacokinetic and safety study of the use of 3HP together with dolutegravir. Country implementation of the project and patients starting 3HP will commence in PLHIV or child contacts once the results of the PK/Safety study are finalized (expected in Quarter 1 2019).

The impact we are seeking

The World Health Organization’s End TB Strategy calls for expanding preventive therapy for TB, particularly through short-course drug regimens, which is precisely what The Aurum Institute’s project sets out to accomplish. The project seeks not only to immediately save lives and reduce disease, but to generate evidence about the treatment regime that can be used to contribute to WHO’s preventive therapy guidelines.