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Unfortunately, INH is associated with serious adverse events, including hepatotoxicity. Although risk factors for this complication are well established, allowing for better selection of candidates for therapy, this complication still occurs, and is occasionally fatal. Hence close follow up of patients is necessary, increasing the cost and complexity of treatment. This problem, plus the lengthy duration, results in poor acceptance by patients and providers, and poor adherence by patients. As a result, many preventable cases of tuberculosis continue to occur, and the public health impact of latent tuberculosis infection treatment is suboptimal. These problems have spurred interest in finding shorter, safer and cheaper alternative regimens, with similar efficacy. Of the many regimens that have been examined, 2\u2003months of rifampin and pyrazinamide has excellent efficacy\u2014in experimental studies in mice and randomized trials, largely in HIV\u2010infected persons. However, while the safety of 2\u2003months of rifampin and pyrazinamide appears acceptable in HIV\u2010infected persons and children, in non\u2010HIV\u2010infected adults this regimen is associated with an unacceptably high rate of severe liver toxicity. Three to four months of INH and rifampin has had equivalent effectiveness as 6\u2003months INH in several randomized trials. However, completion of therapy and toxicity has been the same as with INH\u2014possibly because two drugs are taken rather than one. The fourth commonly studied regimen is 4\u2003months rifampin. This has been found to have significantly better completion than 9H, with significantly less toxicity, especially hepatotoxicity. However, only one trial has evaluated efficacy and effectiveness of mono\u2010rifampin therapy. In this trial, 3\u2003months rifampin had somewhat better efficacy than either 3 months of isoniazid and rifampin (3HR) or 6\u2003months isoniazid. Two large scale trials are ongoing; one is comparing efficacy and effectiveness of 9H with 4\u2003months rifampin (both daily and self\u2010administered), while the second, which is nearing completion, compares daily self\u2010administered 9H with 3\u2003months directly observed once weekly INH combined with rifapentine. The results of these two trials will likely shape future recommendations substantially.<\/jats:p>","DOI":"10.1111\/j.1440-1843.2010.01751.x","type":"journal-article","created":{"date-parts":[[2010,4,9]],"date-time":"2010-04-09T08:12:19Z","timestamp":1270800739000},"page":"603-622","source":"Crossref","is-referenced-by-count":155,"title":["Treatment of latent tuberculosis infection: An update"],"prefix":"10.1111","volume":"15","author":[{"given":"Philip","family":"LOBUE","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"MENZIES","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,4,28]]},"reference":[{"key":"e_1_2_8_2_2","first-page":"1","article-title":"Prevention of experimental tuberculosis with isoniazid","volume":"73","author":"Ferebee SH","year":"1956","journal-title":"Am. Rev. 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