Isoniazid preventive therapy, hepatitis C vires infection, and hepatotoxicity among injection drug users infected with Mycobacterium tuberculosis

Pankaj Sadaphal, Jacquie Astemborski, Neil M.H. Graham, Laura Sheely, Margaret Bonds, Azalia Madison, David Vlahov, David L. Thomas, Timothy R. Sterling

Research output: Contribution to journalArticlepeer-review

Abstract

Treatment of latent Mycobacterium tuberculosis infection with isoniazid can cause hepatotoxicity, but the risk of isoniazid-associated hepatotoxicity among persons coinfected with hepatitis C virus (HCV) is unknown. We conducted a prospective study among 146 injection drug users with M. tuberculosis infection and normal baseline hepatic transaminase values who were treated with isoniazid. Of 146 participants, 138 (95%) were HCV-seropositive. Thirty-seven participants (25%) were human immunodeficiency virus (HIV)-seropositive. Thirty-two (22%; 95% confidence interval [CI], 16%-30%) of 146 participants developed transaminase value elevations to >3 times the upper limit of normal. Transaminase value elevation was associated with concurrent alcohol use but not with race, age, presence of hepatitis B surface antigen, HIV-1 infection, or current injection drug use. Isoniazid was withdrawn from 11 participants (8%; 95% CI, 4%-13%). Of 8 deaths during followup, none were attributed to isoniazid-associated hepatotoxicity. The risk of transaminase value elevation and drug discontinuation for HCV-infected persons receiving isoniazid was within the range reported for populations with lower HCV prevalence.

Original languageEnglish (US)
Pages (from-to)1687-1691
Number of pages5
JournalClinical Infectious Diseases
Volume33
Issue number10
DOIs
StatePublished - Nov 15 2001

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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