Annexure 5 TPT Dosing Tables
TPT Regimens for Children Weighing Less than 25 Kilograms Recommended Daily Dosages for 3RH in HIV-Negative Children <25kg Recommended Daily Dosages for 6H amongst Children Living with HIV < 25kg TPT REGIMENS FOR CHILDREN WEIGHING LESS THAN 25 KILOGRAMS There are two potential regimens for children: 3RH (rifampicin and isoniazid for 3 months), and 6H (isoniazid for 6 months). The
TPT Regimens for Children Weighing Less than 25 Kilograms
Recommended Daily Dosages for 3RH in HIV-Negative Children <25kg
Recommended Daily Dosages for 6H amongst Children Living with HIV < 25kg
TPT REGIMENS FOR CHILDREN WEIGHING LESS THAN 25 KILOGRAMS
There are two potential regimens for children: 3RH (rifampicin and isoniazid for 3 months), and 6H (isoniazid for 6 months). The choice depends on the child’s weight, HIV status or HIV exposure (maternal HIV) status:
- in HIV-negative children < 25kg, the priority regimen is 3RH
- in children living with HIV and on DTG (dolutegravir) containing ART, the preferred regimen is 6H to avoid drug-drug interactions with ART
- in infants born to HIV-positive women (HIV-exposed but HIV-negative infants) on nevirapine, 6H is the priority regimen as rifampicin lowers nevirapine levels below efficacy
All children and breastfeeding infants require pyridoxine (vitamin B6) for the duration of their TPT as follows: Children younger than five years 12.5 mg and children five years or older 25 mg, once daily. Lack of pyridoxine access should not be a barrier to receiving TPT.
For HIV-positive infants who have just had the Bacillus Calmette-Guérin (BCG) vaccine and are not TB-exposed, TPT should be deferred for 14 weeks as Isoniazid (INH) impairs the effect of live BCG (M.bovis BCG) vaccine.
1. RECOMMENDED DAILY DOSAGES FOR 3RH IN HIV-NEGATIVE CHILDREN <25KG
| Child’s Weight (kg) | RH (Daily) fixed dose combinations | Duration | |
| 75 / 50 | If dispersed in water | ||
| 2 - 2.9 | ½ tablet | 5ml | 3 months |
| 3 - 3.9 | ¾ tablet | 7.5ml | |
| 4 - 5.9 | 1 tablet | 10ml | |
| 6 - 7.9 | 1 ½ tablet | 15ml | |
| 8 - 11.9 | 2 tablets | 20ml | |
| 12 - 15.9 | 3 tablets | 30ml | |
| 16 - 24.9 | 4 tablets | 40ml | |
| ≥ 25 | Use adult formulations and doses | ||
2. RECOMMENDED DAILY DOSAGES FOR 6H AMONGST CHILDREN LIVING WITH HIV < 25KG
| Weight band (kg) | Daily INH 100mg tablet | Duration |
| 2 - 3.4 | ¼ tablet | 6 months |
| 3.5 - 4.9 | ½ tablet | |
| 5 - 7.4 | ¾ tablet | |
| 7.5 - 9.9 | 1 tablet | |
| 10 - 14.9 | 1½ tablet | |
| 15 - 19.9 | 2 tablets | |
| 20 - 24.9 | 3 tablets (or one 300mg tablet) | |
| ≥ 25 | Use adult formulations (maximum dose 300 mg per day) | |
South African National Department of Health, Guideline for Vertical Transmission Prevention of Communicable Infections, Version 2_August 2023