P2.170 Outcomes of Isoniazid Prophylaxis Among HIV-Infected Children in Routine Clinical Settings in Kenya

Background In 2011, the TB and HIV control programmes commenced a phased isoniazid prophylaxis therapy (IPT) implementation in selected public hospitals in Kenya. We report outcomes from the first three public health facilities’ HIV care clinics to provide this service. We established rates of treatment completion, loss-to-follow up, mortality, adverse drug reactions and TB disease among HIV-infected children during 6 months of IPT. Methods A retrospective records review of all HIV-infected children (1–14 years) enrolled on IPT from 1st september 2011 and had completed by 30th november 2012. They were screened for TB using a standardised symptom tool developed by the Division of Leprosy, TB and Lung Disease, Kenya. Results We reviewed 606 children, 93.7% were on HAART. IPT successfully completed by 556 (92%) children. Four (0.7%) were lost-to-follow up and treatment interruptions of 5–33 days reported in 24 children (4%). Twenty four children (4%) had treatment interruption of 5–33 days; twenty of them were assigned an equivalent number of days to cover for the interruption while the rest (4) were among those discontinued. Adverse drug reactions and deaths were reported in 2 children (0.3%) respectively. Prophylaxis was discontinued in 24 (4%) children for various reasons. This includes 18 children (3%) diagnosed with TB in a median time of 3 weeks post IPT initiation. 77.8% of all the children who developed TB while on IPT had advanced HIV disease at baseline. Isoniazid resistance was not detected in the four culture confirmed tuberculosis cases. Conclusion The findings of high treatment completion, low loss-to-follow up rate and few adverse drug reactions affirm the feasibility and safety of IPT provision to HIV-infected children in routine settings, but incident TB during the first weeks suggests inadequacy of the symptom screening tool in severely immune-compromised children.