Three months of weekly rifapentine plus isoniazid is less hepatotoxic than nine months of daily isoniazid for LTBI

Details

• Alternative Title:
  Int J Tuberc Lung Dis
• Personal Author:
  Bliven-Sizemore, E. E. ; Sterling, T. R. ; Shang, N. ; Benator, D. ; Schwartzman, K. ; Reves, R. ; Drobeniuc, J. ; Bock, N. ; Villarino, M. E.
• Corporate Authors:
  TB Trials Consortium
• Description:
  SETTING
  
  Nine months of daily isoniazid (9H) and 3 months of once-weekly rifapentine plus isoniazid (3HP) are recommended treatments for latent tuberculous infection (LTBI). The risk profile for 3HP and the contribution of hepatitis C virus (HCV) infection to hepatotoxicity are unclear.
  
  OBJECTIVES
  
  To evaluate the hepatotoxicity risk associated with 3HP compared to 9H, and factors associated with hepatotoxicity
  
  DESIGN
  
  Hepatotoxicity was defined as aspartate aminotransferase (AST) >3 times the upper limit of normal (ULN) with symptoms (nausea, vomiting, jaundice, or fatigue), or AST >5 × ULN. We analyzed risk factors among adults who took at least 1 dose of their assigned treatment. A nested case-control study assessed the role of HCV.
  
  RESULTS
  
  Of 6862 participants, 77 (1.1%) developed hepatotoxicity; 52 (0.8%) were symptomatic; 1.8% (61/3317) were on 9H and 0.4% (15/3545) were on 3HP (P < 0.0001). Risk factors for hepatotoxicity were age, female sex, white race, non-Hispanic ethnicity, decreased body mass index, elevated baseline AST, and 9H. In the case-control study, HCV infection was associated with hepatotoxicity when controlling for other factors.
  
  CONCLUSION
  
  The risk of hepatotoxicity during LTBI treatment with 3HP was lower than the risk with 9H. HCV and elevated baseline AST were risk factors for hepatotoxicity. For persons with these risk factors, 3HP may be preferred.
  
  
• Subjects:
  Adult Antitubercular Agents Article Aspartate Aminotransferases Case-Control Studies Chemical And Drug Induced Liver Injury Drug Administration Schedule Drug Therapy, Combination Female Hepatitis C Humans Isoniazid Latent Tuberculosis Male Middle Aged Multivariate Analysis Rifampin Risk Factors

  More +
• Source:
  Int J Tuberc Lung Dis. 19(9):1039-v
• Pubmed ID:
  26260821
• Pubmed Central ID:
  PMC5080618
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States ; P30 AI094189/AI/NIAID NIH HHS/United States
• Place as Subject:
  Brazil ; Canada ; Spain ; United States
• Volume:
  19
• Issue:
  9
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:bb27208d497a132220fdff79d0b5aeaa00b76ec4779bb55df23ea5d7deba9229
• Download URL:
  https://stacks.cdc.gov/view/cdc/42295/cdc_42295_DS1.pdf
• File Type:
  [PDF - 373.43 KB ]