HEPATOTOXICITY FROM ISONIAZID AND RIFAMPIN IN INNER-CITY AIDS PATIENTS

Objective: To determine the incidence of hepatotoxicity due to isoniaz id and rifampin in inner-city patients with active tuberculosis. Desig n: A hospital-based review of 70 consecutive in-patients in a 770-bed, inner-city hospital. The patient population is primarily African-Amer ican and Hispanic. Methods: Fifty-eight men and 12 women were followed from 2-12 wk (median 4 wk). Patients had to be treated for at least 2 wk to be eligible for the study. Patients were excluded if they had b een on any anti-tuberculous or any other hepatotoxic drug during the 2 -month period before their hospitalization. Aminotransferases, alkalin e phosphatase, bilirubin, and albumin were obtained at least every 2 w k. Results: Hepatocellular toxicity, defined as AST and/or ALT greater than 200 IU/L, occurred in eight out of 70 (11.4%) patients. The mean age of these patients was 38.9 yr (22-58 yr). Patients with AIDS were significantly more likely to develop hepatotoxicity than those with a ny other risk factor (p < 0.01). Conclusions: Baseline aminotransferas es followed by monitoring may be necessary in AIDS patients.