In which situations might the duration of INH therapy be extended?

The duration of isoniazid (INH) therapy may be extended, particularly in cases involving high-risk individuals or those who are immunocompromised. Patients with compromised immune systems, such as those living with HIV/AIDS or undergoing immunosuppressive therapy, have a significantly greater risk of developing active tuberculosis (TB) if exposed. Extending treatment in these populations is critical to ensure adequate prevention of TB disease due to their higher susceptibility.

In contrast, patients with mild symptoms of tuberculosis might not require an extended duration of therapy, as their treatment could be effectively managed within standard protocols. Similarly, while a lack of side effects and a family history of tuberculosis are valid considerations, they do not directly correlate with the need to extend treatment duration in the same way that a high-risk status does. The focus remains on the patient’s individual risk factors, particularly regarding immunocompromised conditions, which warrant closer management and potentially longer treatment courses to prevent disease progression.