Since the introduction of new recommendations for the treatment of latent MTB infection disregarding age as a limitation, larger numbers of older individuals are expected to undergo treatment with INH for the prevention of tuberculosis, raising the potential for INH-induced hepatitis. To assess this potential for increase in INH-induced hepatitis, we reviewed our experience with this group of patients.
We retrospectively reviewed the medical records of 300 patients (178 males, 122 females, age range: 15-65 yrs; mean age:32.4 yrs) who underwent treatment with INH for latent MTB infection for a period of 9 months. All patients had a positive PPD (5 TU) skin test as per CDC criteria for various groups. All patients had normal base-line liver function tests (LFTs). Patients were divided into two groups based on age: group I: age <35 yrs (165 patients; mean age:20.8 yrs) and group II: age 335 yrs (135 patients; mean age:46.6 yrs). Follow-up LFTs were obtained based on clinical suspicion for INH-hepatitis.
Of 165 patients in group I, 3 (2%) patients developed hepatitis (SGOT>3 times the upper limits of normal). Two of 3 patients admitted to alcohol abuse while 1 had no other risk factors. Of 135 patients in group II, 4 (3%) patients developed hepatitis. Two of 4 had history of alcohol abuse; one was on concomitant statin therapy and one had no other risk factors. Statistical comparison between the two groups failed to show significant difference in the frequency of INH-induced hepatitis (P=0.806).
There was no difference in the frequency of INH-induced hepatitis between the two groups.
Treatment of latent MTB infection in patients 335 yrs of age appears to be relatively safe. Age<35≥35Total number165135INH completed for 9 months162 (98%)131 (97%)INH discontinued (due to side effects)3 (2%)4 (3%)Discontinued due to INH-induced hepatitis alone1 (1%)1 (1%)Discontinued due to INH-hepatitis and other reasons2 (1%)3 (2%)
H. Aziz, None.