Authors: Aziz, Hany¹; Shubair, Mohammed¹; DeBari, Vincent A.²; Ismail, Medhat¹; Khan, M. Anees¹

Source: Current Medical Research and Opinion, Volume 22, Number 1, January 2006 , pp. 217-221(5)

Publisher: Informa Healthcare

Abstract:

Background: Since the introduction of new recommendations for the treatment of latent tuberculosis infection (LTB1) disregarding age as a limitation, increasing numbers of older individuals are expected to undergo treatment with isoniazid for the prevention of tuberculosis, raising the potential for an increase in isoniazid hepatotoxicity.

Objective: To compare the frequency of hepatotoxicity requiring withdrawal of isoniazid therapy for LTB1 in patients under and over 35 years of age, managed according to current practice guidelines.

Design: A retrospective analysis of 300 patients who underwent isoniazid therapy for LTB1 according to a protocol based on the current practice guidelines.

Setting: Public health clinic of Passaic County, NJ

Main outcome measures: The frequency of symptomatic isoniazid hepatitis in various age groups.

Results: Of 165 patients < 35 years of age, 3(2%) patients developed hepatitis (AST > 3 times the upper limit of normal). Of 135 patients ≥ 35 years of age, 4(3%) patients developed hepatitis. Statistical comparison between the two groups failed to show a significant difference (p = 0.705).

Conclusions: No difference was detected in the frequency of isoniazid hepatotoxicity between patients < 35 and ≥ 35 years of age. Clinically monitored isoniazid therapy of LTB1 patients ≥ 35 years of age may not predispose subjects to an increased risk of hepatotoxicity. Limitations of this work include the small sample size and the retrospective nature of the study.

Keywords: HEPATOTOXICITY; ISONIAZID; LIVER FUNCTION; TUBERCULOSIS INFECTION

Document Type: Case report

DOI: http://dx.doi.org/10.1185/030079906X80387

Affiliations: 1: Pulmonary Division, Department of Medicine, St. Joseph's Regional Medical Center, Paterson, NJ, USA; School of Graduate Medical Education, Seton Hall University, South Orange, NJ, USA 2: School of Graduate Medical Education, Seton Hall University, South Orange, NJ, USA

Publication date: 2006-01-01

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