Division of Pneumology, Geneva University Hospitals, 4, rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland.
Swiss Med Wkly. 2011 Aug 15;141:w13240. doi: 10.4414/smw.2011.13240. eCollection 2011.
To compare rates of treatment interruption because of side effects and completion rates between subjects treated for latent tuberculosis infection (LTBI) by isoniazid (INH) for 6 months and subjects treated with rifampicin (RIF) for 4 months.
Retrospective analysis of all patients treated for LTBI by INH (1993-2002) or RIF (2004-2007) based on a database including age, gender, prior liver diseases, alcohol consumption, completion rates, time and cause of interruption and monthly analysis of ASAT and ALAT.
624 subjects were included, 426 treated by INH and 198 by RIF. Gender, origin, history of prior hepatic disease and alcohol excess did not differ between groups. Treatment interruption because of hepatotoxicity was significantly higher in the INH group than in the RIF group (6.1% vs 2.0%; p = 0.03). Completion of treatment was significantly higher in the RIF group compared to the INH group (83% vs 74%; p = 0.02).
A 4-month RIF treatment was associated with significantly less interruption of treatment because of hepatotoxicity and higher completion rates compared to a 6-month INH regimen. These results support the RIF regimen as an alternative to the presently recommended 9 months of INH in clinical practice.
比较用异烟肼（INH）治疗 6 个月和用利福平（RIF）治疗 4 个月治疗潜伏性结核感染（LTBI）的患者因副作用而中断治疗的发生率和完成率。
根据包括年龄、性别、既往肝脏疾病、饮酒、完成率、中断时间和原因以及每月天门冬氨酸氨基转移酶（ASAT）和丙氨酸氨基转移酶（ALAT）分析在内的数据库，对所有用 INH（1993-2002 年）或 RIF（2004-2007 年）治疗 LTBI 的患者进行回顾性分析。
共纳入 624 例患者，其中 426 例接受 INH 治疗，198 例接受 RIF 治疗。两组间的性别、来源、既往肝脏疾病史和酒精过量史无差异。因肝毒性而中断治疗的发生率在 INH 组明显高于 RIF 组（6.1%比 2.0%；p=0.03）。RIF 组的治疗完成率明显高于 INH 组（83%比 74%；p=0.02）。
与 6 个月的 INH 方案相比，4 个月的 RIF 治疗因肝毒性而中断治疗的发生率显著降低，完成率显著提高。这些结果支持在临床实践中用 RIF 方案替代目前推荐的 9 个月 INH 方案。
