Programmatic effectiveness of tuberculosis preventive treatment for people with HIV in six high-tuberculosis-burden countries (PROTECT): a prospective cohort study and meta-analysis.
Lancet HIVAug 17, 2026 (epub)
N Sarita Shah, Fadimatu Mishara, Seth Zissette et al.
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In 30 seconds
This prospective cohort study and meta-analysis evaluated the effectiveness of tuberculosis preventive treatment (TPT) in reducing tuberculosis incidence and all-cause mortality among 235,424 people with HIV initiating antiretroviral therapy (ART) across six high-burden countries. The pooled hazard ratio for tuberculosis was 0.39 (95% CI 0.34-0.43), indicating a significant reduction in incidence.
Key findings
- The pooled hazard ratio for tuberculosis was 0.39 (95% CI 0.34-0.43), showing a significant reduction in incidence.
- The adjusted hazard ratio for mortality was 0.55 (95% CI 0.51-0.58), indicating a notable decrease in all-cause mortality.
- TPT effectiveness varied by country, with mortality HRs ranging from 0.25 in Uganda to 0.69 in Zimbabwe.
Why it matters
The findings underscore the importance of tuberculosis preventive treatment in HIV care, particularly as ART access expands. Clinicians should consider TPT as a critical component of comprehensive care for people living with HIV to improve health outcomes.