Disturbed hepatic function during isoniazid chemoprophylaxis. Monitoring the hepatic function of 427 hospital employees receiving isoniazid chemoprophylaxis for tuberculosis.

Abstract

Of 427 hospital employees receiving isoniazid chemoprophylaxis for 4 to 8 months, elevations of serum glutamic oxalacetic transaminase (SGOT) developed in 37. Isoniazid was discontinued in 5 because they also had symptomatic hepatitis and in 8 others who were asymptomatic because they also had abnormal serum values of total bilirubin or alkaline phosphatase or both. in 24 subjects, however, SGOT elevations were the only indications of hepatic injury. Testing their hepatic function biweekly or monthly enabled evaluation of criteria based on SGOT limits for interrupting their chemoprophylaxis. Treatment with isoniazid was stopped whenever the SGOT exceeded 100 units (upper limits of normal: 50 units) on two occasions, or whenever SGOT exceeded 250 units on one occasion. As a result, isoniazid was stopped in 5 subjects with elevations of SGOT. It was continued in 19 others, who remained asymptomatic; their tests after completion of chemoprophylaxis showed normal values for SGOT. in this population, these cri...