.png){kind=icon}
.png){kind=icon}
Return
Outcomes of isoniazid preventive therapy in pregnant women living with HIV: A systematic review and meta-analysis
.png){kind=icon}
PRE
AI
S
H
B
U
B
A
DOI：10.1177/03946320261427990.png)
.png){kind=icon}
Original request for help.png){kind=icon}
Share.png){kind=icon}
Save
Abstract
En 中文
<jats:sec>
<jats:title>Objective:</jats:title>
<jats:p>To evaluate the safety and effectiveness of isoniazid preventive therapy (IPT) in pregnant women living with HIV (WLWH) through a systematic review and meta-analysis.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Introduction:</jats:title>
<jats:p>Isoniazid preventive therapy (IPT) is recommended for preventive treatment of tuberculosis in high risk groups. However, evidence on its role in pregnant WLWH remains scarce.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>We performed a systematic review and meta-analysis to pool randomized controlled trials (RCTs) as well as non-randomized studies (NRS) where IPT was administered to pregnant WLWH (PROSPERO ID: CRD42024618836). PubMed, Embase, and Cochrane Central databases were searched for relevant articles, until November 15, 2024. Statistical analysis was performed using R Software v4.4.1 and a random-effects model was applied to pool risk ratios (RRs) along with 95% confidence intervals.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>
Five studies with a total of 45,402 patients (mean age = 30 years) were included. The risk of maternal mortality was significantly decreased in pregnant WLWH exposed to IPT compared with the control group (RR 0.42; 95% CI 0.20–0.92;
<jats:italic toggle="yes">p</jats:italic>
= 0.03). However, the risks of other outcomes including composite adverse pregnancy outcome (RR 0.90; 95% CI 0.56–1.43;
<jats:italic toggle="yes">p</jats:italic>
= 0.66), prematurity (RR 0.86; 95% CI 0.46–1.60;
<jats:italic toggle="yes">p</jats:italic>
= 0.63), low birthweight (RR 0.99; 95% CI 0.69–1.42;
<jats:italic toggle="yes">p</jats:italic>
= 0.95), very low birthweight (RR 1.28; 95% CI 0.39–4.23;
<jats:italic toggle="yes">p</jats:italic>
= 0.55), congenital anomalies (RR 1.48; 95% CI 0.59–3.75;
<jats:italic toggle="yes">p</jats:italic>
= 0.41), and hepatotoxicity (RR 0.99; 95% CI 0.71–1.37;
<jats:italic toggle="yes">p</jats:italic>
= 0.93) were comparable between the two groups.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusion:</jats:title>
<jats:p>IPT in pregnant WLWH significantly reduces maternal mortality without increasing adverse pregnancy outcomes. These findings support the continued use of IPT during pregnancy, with careful monitoring for hepatotoxicity, and highlight its potential role as an important maternal health intervention in high TB/HIV burden regions.</jats:p>
</jats:sec>
Keywords:
Isoniazid preventive therapy
Pregnant women
HIV
Tuberculosis
Maternal mortality
Journal
I
IF:
2.6
Papers:
2.3K
Citations:
3.1K
Organization
Cited Papers