[Hepatotoxicity of the combination of isoniazid-rifampicin in African children. Role of malnutrition and HB virus].
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.
Gendrel
D
D
Centre Universitaire des Sciences de la Santé et Hôpital Pédiatrique d'Owendo, Libreville, Gabon.
Nardou
M
M
Mouba
J F
JF
Gahouma
D
D
Moussavou
A
A
Boguikouma
J B
JB
D000293:Adolescent; D000349:Africa; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004338:Drug Combinations / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D007223:Infant; D007538:Isoniazid / Q000009:adverse effects* / Q000627:therapeutic use; D008099:Liver / Q000187:drug effects; D008297:Male; D009748:Nutrition Disorders / Q000150:complications*; D012293:Rifampin / Q000009:adverse effects* / Q000627:therapeutic use; D000637:Transaminases / Q000097:blood; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy*
D004338:Drug Combinations; D000637:Transaminases; D007538:Isoniazid; D012293:Rifampin
Hépatotoxicité de l'association isoniazide-rifampicine chez l'enfant africain. Influence de la malnutrition et du virus HB.