Benefit-risk of TB prevention treatment for people with diabetes

TB has caused the most deaths than any other infectious disease worldwide. Disease can be prevented by giving antibiotics to people who are infected with TB. People with diabetes have an increased risk for TB. However, the WHO currently does not recommend antibiotics for these individuals since there is not enough evidence to inform this decision. Benefit of prevention may be limited since treatment of diabetes could reduce the risk of TB. One month of the TB drugs rifapentine and isoniazid (1HP) may offer benefit that outweigh potential harm but this is unknown. We will conduct a study in South Africa to assess the added effect and safety of 1HP in people with diabetes who are HIV-uninfected, likely infected with TB and and receive optimal diabetes care. The study will place them in a random manner to a group that receives 1HP or a group that receives diabetes care alone.