# PREVINE-TB: PRevent: EValuating the implementation of NEw strategies for preventive TB among people living with HIV in Brazil

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2022 · $571,907

## Abstract

PROJECT SUMMARY
Despite being a preventable and treatable disease, tuberculosis (TB) kills just under 2 million people annually,
and vulnerable populations, especially people living with HIV (PLWH), are at highest risk for disease and
death. In Brazil, TB rates are markedly higher in PLWH and preventing TB for PLWH is a top priority. However,
our prior work in Rio de Janeiro estimated only 12% of eligible PLWH receiving TB preventive therapy annually
and identified two critical constraints to delivery of effective TB preventive therapy among PLWH: tuberculin
skin testing (TST) for latent TB infection (LTBI) and adherence to 6 months of isoniazid preventive therapy
(IPT). With QFT+, a 4th generation Interferon Gamma Release Assay, LTBI status can be determined as part of
routine blood draws without the patient having to return to the clinic. This strategy has the potential to
substantially improve the TB/HIV prevention continuum. PREVINE-TB (PRevent: EValuating the
Implementation of NEw strategies for preventing TB among people living with HIV in Brazil) will test
use of QFT+ and compare adherence strategies to optimize implementation of the TB prevention
continuum in HIV clinics in Brazil. A switch from daily isoniazid to the novel 3HP regimen (once weekly for
12 weeks), now recommended by the CDC, may improve patient adherence, but may also be a challenge in
not being part of a daily routine. The 3HP regimen was recently added to guidelines for PLWH as an
alternative to the 6-month course of IPT in Brazil, but the best method for implementing 3HP is yet to be
determined. PREVINE-TB has the potential to increase uptake for this at-risk population in a setting where
PLWH have been shown (by our team) to significantly benefit from preventive therapy. Our goal is to assess
the implementation by the Brazilian National Tuberculosis Program (NTP) of a novel strategy to
prevent TB among PLWH in Brazil. Aim 1 will focus on QFT+ as a strategy to increase screening for LTBI as
part of routine care for PLWH. We will determine the effectiveness and costs of QFT+ linked to routine viral
load and CD4 blood draws to optimize the TB/HIV prevention care continuum. Aim 2 will determine
effectiveness and cost-effectiveness of three scalable methods for optimizing patient adherence to 3HP. We
will conduct an individually randomized non-inferiority trial of adherence for PLWH eligible for 3HP to compare
clinic-based directly observed therapy (DOT, the current standard-of-care) vs self-administered therapy (SAT)
with optimized text messaging. Finally, we will utilize (Aim 3) the Consolidated Framework for Implementation
Research (CFIR) to optimize intervention processes and describe key elements for the successful
implementation of the QFT+ and 3HP strategies to inform scale-up and maintenance. Using a mixed methods
approach, we will explore perspectives from three stakeholder groups (patients, providers, and program
managers/policy makers) to build and improve optima...

## Key facts

- **NIH application ID:** 10426171
- **Project number:** 5R01AI131796-05
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** JONATHAN E. GOLUB
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $571,907
- **Award type:** 5
- **Project period:** 2018-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10426171

## Citation

> US National Institutes of Health, RePORTER application 10426171, PREVINE-TB: PRevent: EValuating the implementation of NEw strategies for preventive TB among people living with HIV in Brazil (5R01AI131796-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10426171. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*
