TY - JOUR
T1 - Isoniazid preventive therapy, hepatitis C vires infection, and hepatotoxicity among injection drug users infected with Mycobacterium tuberculosis
AU - Sadaphal, Pankaj
AU - Astemborski, Jacquie
AU - Graham, Neil M.H.
AU - Sheely, Laura
AU - Bonds, Margaret
AU - Madison, Azalia
AU - Vlahov, David
AU - Thomas, David L.
AU - Sterling, Timothy R.
N1 - Funding Information:
Financial support: National Institute of Drug Abuse (grant DA 07061, DA 04334), National Institute of Allergy and Infectious Diseases (grant AI 01654), and Fogarty International Center/USNIH (grant 3 D 43 TW 000010-11S1-TBITRP).
PY - 2001/11/15
Y1 - 2001/11/15
N2 - 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 Isoniazid was withdrawn from 11 participants (8%; 95% CI, 4%-13%).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.
AB - 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.
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U2 - 10.1086/323896
DO - 10.1086/323896
M3 - Article
C2 - 11641824
AN - SCOPUS:0035889486
SN - 1058-4838
VL - 33
SP - 1687
EP - 1691
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 10
ER -