Isoniazid-induced hepatotoxicity in children with latent tuberculosis infection

Minerva Pediatr (Torino). 2021 Apr;73(2):184-187. doi: 10.23736/S2724-5276.17.04338-9. Epub 2015 Sep 17.

Abstract

Background: We aimed to determine overall incidence of severe and mild isoniazid (INH) hepatotoxicity and outcome of hepatotoxicity in children who were receiving INH for latent tuberculosis.

Methods: Patients who had received isoniazid for treatment of latent tuberculosis were included in the study. Hepatotoxicity was classified according to the World Health Organization Toxicity Classification Standards.

Results: Among 1038 patients, overall hepatotoxicity was observed in 22 patients (2.2%), while 5 patients (0.48%) had moderate-severe hepatotoxicity; while other 17 patients had grade I-II hepatotoxicity (1.63%). Age and gender did not appear to be risk factors for hepatotoxicity. The median time for therapy rechallenge in patients with grade III-IV hepatotoxicity was 21 days (ranging from 14 to 25 days).

Conclusions: Isoniazid hepatotoxicity is lower and generally reversible after cessation of INH in children. The grade of hepatotoxicity affects the duration for recovery of hepatotoxicity and restarting of INH therapy.

MeSH terms

  • Adolescent
  • Antitubercular Agents / adverse effects*
  • Chemical and Drug Induced Liver Injury / epidemiology*
  • Chemical and Drug Induced Liver Injury / pathology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Isoniazid / adverse effects*
  • Latent Tuberculosis / drug therapy*
  • Male

Substances

  • Antitubercular Agents
  • Isoniazid