Isoniazid-Induced Severe Hepatotoxicity: An Infrequent but Preventable Cause of Liver Failure in Children Treated for Latent Tuberculosis Infection

Isoniazid (INH) monotherapy has gained widespread acceptance as an efficacious therapy for latent tuberculosis infection (LTBI) especially in low-prevalence settings. Although INH related hepatotoxicity is well recognized, progression to severe liver dysfunction requiring care at a transplant center remains unpredictable. We report the management of a five year-old girl who developed progressive liver failure due to INH prophylaxis. This highlights the potential severity of INH related hepatic injury and underscores the significance of vigilant clinical monitoring throughout the duration of the therapy in children.

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S40 A cross sectional investigation to determine the background prevalence of latent tuberculosis infection in unselected medical inpatients in a low prevalence region of UK reveals high rates of IGRA positivity

Thorax ◽

10.1136/thoraxjnl-2011-201054b.40 ◽

2011 ◽

Vol 66 (Suppl 4) ◽

pp. A21-A21

Author(s):

N. Varsani ◽

T. S. C. Hinks ◽

D. T. Godsiff ◽

T. C. Bull ◽

K. L. Nash ◽

...

Keyword(s):

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

Cross Sectional ◽

Medical Inpatients ◽

Low Prevalence

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Low Prevalence of Latent Tuberculosis Infection among Contacts of Smear-Positive Adults in Brazil

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.19-0100 ◽

2019 ◽

Vol 101 (5) ◽

pp. 1077-1082

Author(s):

Andreza Oliveira-Cortez ◽

Emerson Lopes Froede ◽

Angelita Cristine de Melo ◽

Clemax Couto Sant’Anna ◽

Leonardo Araújo Pinto ◽

...

Keyword(s):

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

Low Prevalence

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QuantiFERON-TB Testing for Latent Tuberculosis Infection in Low-Prevalence Countries: Making the Most of an Imperfect Process

Infection Control and Hospital Epidemiology ◽

10.1086/662022 ◽

2011 ◽

Vol 32 (10) ◽

pp. 1055-1055 ◽

Cited By ~ 1

Author(s):

William J. Schneider ◽

Arthur E. Brown ◽

Cynthia Eisenstein

Keyword(s):

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

Low Prevalence

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Latent Tuberculosis Infection Screening and 2-Year Outcome in Antiretroviral-Naive HIV-Infected Patients in a Low-Prevalence Country

Annals of the American Thoracic Society ◽

10.1513/annalsats.201412-600oc ◽

2015 ◽

pp. 150727131311009

Author(s):

Anne Bourgarit ◽

Gabriel Baron ◽

Guillaume Breton ◽

Pierre Tattevin ◽

Christine Katlama ◽

...

Keyword(s):

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

Low Prevalence

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A Targeted Screening Program for Latent Tuberculosis Infection Among Hematopoietic Cell Transplant Recipients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa224 ◽

2020 ◽

Vol 7 (7) ◽

Author(s):

Andrea Sosa-Moreno ◽

Masahiro Narita ◽

Christopher Spitters ◽

Michelle Swetky ◽

Sara Podczervinski ◽

...

Keyword(s):

Risk Factors ◽

Latent Tuberculosis Infection ◽

Screening Program ◽

Latent Tuberculosis ◽

Hematopoietic Cell ◽

Tuberculosis Infection ◽

Tuberculin Skin Testing ◽

Targeted Screening ◽

Low Prevalence ◽

Ltbi Testing

Abstract Background US hematopoietic cell transplantation (HCT) recipients have a low prevalence of latent tuberculosis infection (LTBI), but if latently infected they are at risk for progression to active tuberculosis. At our center, all HCT recipients underwent LTBI testing pretransplant by tuberculin skin testing (TST) until 2013 when we implemented a targeted screening program. Our objective was to assess the utility of our screening program that incorporated a pretransplant LTBI questionnaire to target TST and QuantiFERON TB Gold (QFT) testing. Methods We performed a retrospective cohort study of HCT recipients undergoing first transplant from 2014 to 2016. Patients with positive, indeterminate, and a subset with negative QFT results underwent electronic medical record (EMR) review to assess TST results and risk factors for LTBI. Results Among 1290 eligible recipients, 457 (35%) had at least 1 risk factor for LTBI on the pretransplant questionnaire; nonwhites were more likely to undergo LTBI testing (P < .0001). Overall, 16 of 1290 (1.2%) had at least 1 positive LTBI test. Of those screened by QFT, 14 of 457 (3%) were positive and 52 (11%) were indeterminate. Among those undergoing EMR review, 123 of 267 (46%) had TST records; 4 of 123 (3%) positive by both TST and QFT, and 2 (2%) by TST alone. Two or more risk factors were reported among the majority of LTBI-positive patients (15 of 16 [94%]). All patients with at least 1 positive test for LTBI (n = 16) were evaluated, and 11 of 16 (69%) were recommended to receive treatment. Conclusions Incorporating a pretransplant LTBI questionnaire allowed for an approximate 65% reduction in LTBI testing when compared with universal testing among this low prevalence population.

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