Safety and tolerability of isoniazid preventive therapy for tuberculosis for persons with HIV with and without alcohol use.
Journal
AIDS (London, England)
ISSN: 1473-5571
Titre abrégé: AIDS
Pays: England
ID NLM: 8710219
Informations de publication
Date de publication:
01 08 2023
01 08 2023
Historique:
medline:
17
7
2023
pubmed:
1
6
2023
entrez:
1
6
2023
Statut:
ppublish
Résumé
Isoniazid (INH) preventive therapy is recommended to prevent tuberculosis (TB) disease for persons with HIV (PWH), except for those with regular and heavy alcohol consumption, due to hepatotoxicity concerns. We aimed to quantify the incidence of severe INH-related toxicity among PWH with and without recent alcohol consumption. A prospective study of PWH receiving INH. We included PWH in southwest Uganda with recent (prior 3 months) ( n = 200) or no (prior year) self-reported alcohol consumption ( n = 101), on antiretroviral therapy, TB infected (≥5 mm on tuberculin skin test), and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) 2× or less the upper limit of normal (ULN). Grade 3+ INH-related toxicity was ALT or AST at least 5× the ULN or severe symptoms; we stopped IPT upon detection. Grade 2 INH-related toxicity was ALT or AST 2-5× the ULN or moderate symptoms. The cumulative incidence of Grade 3+ INH-related toxicity was 8.3% [95% confidence interval (95% CI) 5.4-12.0]; all resolved after INH cessation. Incidence was 6.0% (95% CI 3.1-10.2) among those reporting recent alcohol use and 12.9% (95% CI 7.0-21.0) among those reporting no prior year alcohol use. We found no differences by baseline phosphatidylethanol-confirmed alcohol severity. The cumulative incidence of Grade 2 toxicities (without Grade 3+) was 21.7% (95% CI 17.0-27.1); 25.0% (95% CI 19.0-31.8) among those with recent alcohol use and 14.8% (95% CI 8.1-23.9) among those with no prior year alcohol use. Alcohol use does not appear to increase risk for serious INH-related toxicity among PWH without significant liver enzyme elevations at baseline (≤2x ULN).
Identifiants
pubmed: 37260251
doi: 10.1097/QAD.0000000000003613
pii: 00002030-202308010-00006
pmc: PMC10355800
mid: NIHMS1904491
doi:
Substances chimiques
Isoniazid
V83O1VOZ8L
Antitubercular Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1535-1543Subventions
Organisme : NIAAA NIH HHS
ID : U24 AA020779
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI119037
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01 AA020776
Pays : United States
Organisme : NIAAA NIH HHS
ID : K24 AA022586
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI042853
Pays : United States
Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
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