Isoniazid-induced hepatotoxicity in patients with latent tuberculosis – experience from a tuberculosis center

Background

Although the prevalence of isoniazid-induced hepatotoxicity (IIH) has been documented in patients with tuberculosis, its prevalence in latent tuberculosis infection (LTBI) patients is less studied. The aim of this study was to investigate the prevalence of IIH in a group of LTBI patients who received isoniazid monotherapy.

Methods

Retrospective cohort study including patients who underwent isoniazid monotherapy for LTBI in an outpatient clinic between January 1st^, 2020, and June 30th^, 2021.

Results

A total of 274 cases were analyzed. About half (50.4 %) were male; median age was 53 years-old (minimum: six; maximum 89). The most common comorbidities were dyslipidemia (25.5 %), body mass index between 25 and 30 kg/m² (20.4 %), obesity (14.7 %) and chronic hepatic disease (CHD; 12.8 %). 47.4 % had systemic inflammatory diseases. Significant elevation of liver enzymes was documented in 27 % of patients. IIH was documented in 20.4 % of patients; there was a statistically significant relation with dyslipidemia (p < 0.001), CHD (p = 0.023), psoriasis (p = 0.025), spondyloarthropathies (p = 0.017) and male sex (p = 0.042). Dyslipidemia showed a strong correlation to IIH (adjusted odds ratio: 8.045).

Conclusion

Patients with dyslipidemia had an adjusted odds ratio of 8.045 to develop IIH. Future multicentric studies should be started to better explore this relation, as well as treatment options.