{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:16:42Z","timestamp":1790813802623,"version":"4.1.0"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00c3\u00a7\u00c3\u00a3o de Aperfei\u00c3\u00a7oamento de Pessoal de N\u00c3vel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Clinical trials have shown the protective efficacy of tuberculosis preventive treatment (TPT) for averting disease and death from tuberculosis among people living with HIV\/AIDS (PLHIV). TPT has been recommended for PLHIV since the 1980s. However, tuberculosis is still the first cause of death in PLHIV.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>We aimed to summarize the evidence related to the real-world effectiveness of TPT on tuberculosis incidence among PLHIV.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Method<\/jats:title>\n<jats:p>This is a systematic review and meta-analysis of observational cohort studies. The search was carried out in PubMed (via MEDLINE), Embase, LILACS, Scopus and Web of Science databases. Free and controlled vocabulary was used for the searches, with no restrictions on language or publication period. Studies reporting hazard ratios (HR) for tuberculosis incidence among PLHIV who received TPT were pooled using random-effects meta-analysis models. Meta-regression was performed to assess whether study-level characteristics accounted for heterogeneity, as evaluated by Cochran\u2019s I\u00b2 statistic. Study quality was appraised using the Newcastle-Ottawa Scale. This study was registered with PROSPERO (CRD42024586273).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among 8,330 screened studies, 34 were included, with nine contributing to the meta-analysis. TPT was associated with a 63% reduction in tuberculosis incidence risk (HR\u2009=\u20090.37, 95% CI: 0.28\u20130.48; I\u00b2\u2009=\u200943%). Children exhibited consistent stronger protection (82% risk reduction, HR\u2009=\u20090.18, 0.09\u20130.37; I\u00b2\u2009=\u20090%) than adults (56% reduction, HR\u2009=\u20090.44, 0.37\u20130.53; I\u00b2\u2009=\u200921%).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In real world conditions, TPT significantly and substantially reduces tuberculosis incidence in PLHIV, with consistent evidence of stronger protective effects in children. Despite some heterogeneity among adult studies, the pooled evidence confirms the protective effectiveness previously observed in clinical trials. These findings reinforce the global recommendation for broad implementation of TPT among PLHIV.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0330208","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T17:28:28Z","timestamp":1756229308000},"page":"e0330208","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effectiveness of tuberculosis preventive treatment on disease incidence among people living with HIV\/AIDS: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9958-8462","authenticated-orcid":true,"given":"Jos\u00e9 Nildo de Barros","family":"Silva J\u00fanior","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2059-6959","authenticated-orcid":true,"given":"Gilberto da Cruz","family":"Leal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qu\u00e9zia Rosa","family":"Ferreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4115-3022","authenticated-orcid":true,"given":"Licia Kellen de Almeida","family":"Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaqueline Garcia de Almeida","family":"Ballestero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0194-7397","authenticated-orcid":true,"given":"Victor Santana","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00falia M.a","family":"Pescarini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anete","family":"Trajman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Arakaki-Sanchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Bartholomay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5843-1733","authenticated-orcid":true,"given":"Rubia Laine","family":"de Paula Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Pelissari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Fredemir","family":"Palha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"pone.0330208.ref001","volume-title":"Global Tuberculosis Report 2024","author":"World Health Organization","year":"2024"},{"issue":"5","key":"pone.0330208.ref002","article-title":"HIV-Associated Mycobacterium tuberculosis Bloodstream Infection Is Underdiagnosed by Single Blood Culture","volume":"56","author":"DA Barr","year":"2018","journal-title":"J Clin Microbiol"},{"key":"pone.0330208.ref003","unstructured":"World Health Organization. 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