a Department of Health Sciences , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
Expert Rev Anti Infect Ther. 2018 Apr;16(4):359-365. doi: 10.1080/14787210.2018.1441025. Epub 2018 Feb 21.
Isoniazid monotherapy for six or nine months and the combination of isoniazid and rifampicin for three or four months are the most used regimens for treating latent tuberculosis. The main aim of this retrospective study is to evaluate the safety of latent tuberculosis treatment by analysing side effects in both regimens.
Children with latent tuberculosis and treated with isoniazid or isoniazid and rifampicin were included. Periodic evaluations with clinical assessment and blood exams were carried out to detect any adverse reaction, including elevated serum transaminases.
441 children were included, 14.5% treated with isoniazid and 85.5% with isoniazid and rifampicin. Five patients under combined treatment developed hepatotoxicity within the first month. None of the patients under isoniazid monotherapy presented hepatotoxicity. A slight increase of transaminases level was found in both groups (18.7% in isoniazid and 10.3% in isoniazid/rifampicin groups, respectively) without causing discontinuation of treatment, with values normalization at the subsequent checks.
Both regimens resulted safe. Hepatotoxicity occurred rarely and within the first month. For this reason, it may be appropriate to perform liver function tests after about one month from the beginning of therapy to avoid diagnostic delays.
异烟肼单药治疗 6 个月或 9 个月，以及异烟肼和利福平联合治疗 3 个月或 4 个月，是治疗潜伏性结核最常用的方案。本回顾性研究的主要目的是通过分析两种方案中的副作用来评估潜伏性结核病治疗的安全性。
纳入了接受异烟肼或异烟肼和利福平治疗的潜伏性结核儿童。通过临床评估和血液检查定期进行评估，以检测任何不良反应，包括血清转氨酶升高。
共纳入 441 例患儿，14.5%接受异烟肼治疗，85.5%接受异烟肼和利福平联合治疗。联合治疗组中有 5 例患者在第一个月内出现肝毒性。异烟肼单药治疗组无一例出现肝毒性。两组患者的转氨酶水平均略有升高（分别为异烟肼组 18.7%和异烟肼/利福平组 10.3%），但未导致治疗中断，后续检查时均恢复正常。
两种方案均安全。肝毒性罕见且发生在第一个月内。因此，在开始治疗后约一个月左右进行肝功能检查可能是合适的，以避免诊断延迟。
