Hepatitis after Isoniazid Administration

Isoniazid-Associated Hepatitis

“…Although the observations on Capitol Hill strongly suggest that the isoniazid produced acute hepatic injury, the mechanism of its hepatotoxicity was not elucidated. The histopathologic features of liver specimens obtained during this investigation and of previously reported cases (17)(18)(19) were indistinguishable from those of acute viral hepatitis. Epidemiologic observations on the Capitol Hill cases ruled out commonsource infectious hepatitis.…”

“…In 7 .of the 12 in whom isoniazid therapy was continued, serum enzyme concentrations" returned to normal. In 1970, Martin and Arthaud (18) reported the case of a patient with jaundice that seemed to be causally related to isoniazid chemoprophylaxis. This patient manifested symptoms, _signs, and biochemical abnormalities characteristic of hepatitis approximately one month after starting therapy.…”

Isoniazid-Related Hepatitis

“…In the 1960s, it was shown to be effective as a pro phylactic agent in persons with latent infec tion [1][2][3] leading to formal recommenda tions by the American Thoracic Society. It urged therapy with INH for prophylaxis in high-risk groups [4] with ongoing redefinition and liberalization of the treatment criteria [5].This led to mass screening of the popula tion and significant numbers of subjects were treated prophylactically despite numerous anecdotal reports of its potential hepatotoxic ity [6][7][8][9][10][11]. These were largely dismissed due to skepticism and the possibility of interac tion with other antitubercular drugs or con current viral hepatitis.…”

“…Conclusive evidence of INH-related hepa totoxicity was provided by several reports subsequently [12,13], but it was the United States Public Health Service Report in 1972 by Garibaldi et al [14] that gained national attention. Of the 2,321 Capital Hill em ployees on INH chemoprophylaxis, 19 indi viduals developed clinical hepatitis including 2 deaths.…”

Isoniazid liver injury during chemoprophylaxis in children.

“…Several studies have shown there is an asymptomatic rise in the level of SGOT in 10-20% of adults given INH (Scharer and Smith, 1969;Bailey et al, 1973;Mitchell et al, 1975), although clinically overt hepatitis appears to be rare in such patients (Martin and Arthaud, 1970;Garibaldi et al, 1972;Moss et al, 1972;Black et al, 1975;Mitchell et al, 1976).…”