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Published byAlexis Chambers Modified over 8 years ago
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The 12-dose regimen (3HP) Experience from Seattle & King County, WA Masa Narita, MD
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Background The population of King County: 1.9 million Active TB cases: 100-150 cases/yr Foreign-born cases: over 80% Homeless: a challenging group for TB control (one night count: 8000) A large TB outbreak: initially detected in 2002 –67 cases in the first 2 years. The strain still seen Seattle: a site of TBTC Study 26 (PREVENT TB study)
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Roll-out of the 12-dose regimen Idea: shorter process for diagnosis and treatment of LTBI –Use of QFT followed by the use of 12-dose regimen Partners: homeless shelter and day- service agencies
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It takes a village… Besides augmenting partnership, support and commitment of the TB program were essential. –Medical providers, nurses, medical assistants, outreach workers, and database (and more) –Adverse events monitoring
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Two cases of hepatitis 59 yo male, close contact of smear-positive pulmonary TB Baseline: GOT 45, GPT 80, T.Bili 1.2 He reported that he had nausea, fever/chills, and body aches x one day after the 3 rd dose. He was asymptomatic on the day of the 4 th dose. GOT 178, GPT 201, T. Bili 0.6. Rx d/c’d. A week later, GOT 107, GPT 157, T. Bili 0.6, HBsAg negative, HBcAb IgM positive, A& C negative (alk phos remains normal)
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Another case of hepatitis 46 yo male, close contact, Hep C positive Baseline GOT 32, GPT 42 The first month: LFT normal 2 days after the 9 th dose, he complained of dark urine (no other symptoms) GOT 596, GPT 154, Rx d/c’d. 4 days later, 149/119 Then one week later 39/62
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