Hepatotoxicity of the combination of isoniazid-rifampicin in African children. Role of malnutrition and HB virus
Gendrel, D.; Nardou, M.; Mouba, J.F.; Gahouma, D.; Moussavou, A.; Boguikouma, J.B.
Archives Francaises de Pediatrie 46(9): 645-648
1989
ISSN/ISBN: 0003-9764 PMID: 2604523 Document Number: 344744
Forty-seven Gabonese children with tuberculosis either limited to the lung or associated with other localizations were treated with isoniazid-rifampin (INH + RIF). They had liver tests done during the first 6 months of treatment. In 30 patients (63.8%) there was an increase in aminotransferase levels [over 100 UI/l in 14 (29.2%)]. The main factors increasing the risk of hepatic toxicity was a high dosage of INH and overall malnutrition. In fact, the weights of patients presenting with signs of hepatic toxicity were significantly lower than those in children who had no alterations of liver function. 68% of the severely malnourished (marasmus of kwashiorkor) presented with high ALAT or ASAT levels during treatment. The eventual role of the chronic HBV carrier state is discussed as 2 children presented with a chronic form of hepatitis at the time the treatment was initiated.