Tuberculosis Clinical Trial
Official title:
Drugs for Treatment of Latent Tuberculosis Infection Objective 4: Identify Biomarkers for Clinical Trials of Drugs Active Against Latent TB
The purpose of this study is to study the effect that treatment of dormant tuberculosis
infection has on the immunological system.
We expect to observe an impact over the production of cytokines by peripheral white blood
cells which may be useful to know if treatment has been effective.
As part of on-going studies conducted in the Orizaba Health Jurisdiction in southeastern
Mexico, household contacts of pulmonary TB patients who recently converted their tuberculin
test and TST+ve contacts from randomly selected control households with no history of TB
within the last 2 years (remote contacts) will be enrolled. We assume that these individuals
are infected with Mycobacterium tuberculosis. Additional confidence that all subjects
enrolled are latently infected will come from ELISPOT analysis of the response to ESAT-6 and
CFP-10. We propose to administer INH to 100 TST+ve recent and 100 TST+ve remote contacts for
6 months. To control for spontaneous fluctuations of biomarker levels, we propose to defer
therapy by 3 months to half the subjects in each group. Thus, four groups will be defined:
A. Recently converted contacts receiving isoniazid (5mg per kg up to 300 mg daily for 6
months) immediately after recruitment.
B. Recently converted contacts receiving isoniazid (5mg per kg up to 300 mg daily for 6
months) three months after recruitment.
C. Remote contacts receiving isoniazid (5mg per kg up to 300 mg daily for 6 months)
immediately after recruitment.
D. Remote contacts receiving isoniazid (5mg per kg up to 300 mg daily for 6 months) three
months after recruitment.
All contacts will undergo clinical evaluation at enrolment and review. The development of
active TB will trigger withdrawal and full treatment. Fortnightly clinical review of group B
during the deferred phase will be undertaken. ELISPOT analysis will be performed on all
subjects at 0, 1, 4, 13, 26 and 40 weeks in groups A and C, and at 0, 13, 14, 17, 26, 40 and
54 weeks in groups B and D. A subset of 10 patients per group will be sampled for expression
analysis at 0, 4, 26 and 40 weeks (groups A and C) and at 0, 13, 17 and 40 weeks in groups B
and D (160 hybridizations in total).
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