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Volume 147, Issue 5, Pages (May 2015)

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Presentation on theme: "Volume 147, Issue 5, Pages (May 2015)"— Presentation transcript:

1 Volume 147, Issue 5, Pages 1376-1384 (May 2015)
Isoniazid-Associated Hepatitis in Adults Infected With HIV Receiving 36 Months of Isoniazid Prophylaxis in Botswana  Zegabriel Tedla, MD, Minh-Ly Nguyen, MD, Thabisa Sibanda, MBChB, Samba Nyirenda, MD, Tefera B. Agizew, MPhil, MD, Sonali Girde, MD, Charles E. Rose, PhD, Taraz Samandari, MD, PhD  CHEST  Volume 147, Issue 5, Pages (May 2015) DOI: /chest Copyright © 2015 The American College of Chest Physicians Terms and Conditions

2 Figure 1 – Outcomes of isoniazid-associated hepatitis in adults infected with HIV initiating 36 mo of IPT. G1 = EST > upper limit of normal to 2.5-fold upper limit of normal; G2 = EST > 2.5- to 5.0-fold upper limit of normal; G3 = EST > 5.0- to 20.0-fold upper limit of normal; G4 = EST > 20.0-fold upper limit of normal; G5 = death with G4. ART = antiretroviral therapy; EST = elevated serum transaminase; IPT = isoniazid preventive therapy. CHEST  , DOI: ( /chest ) Copyright © 2015 The American College of Chest Physicians Terms and Conditions

3 Figure 2 – Moderate and severe hepatitis among participants receiving 36 mo of isoniazid by study month. Solid portions of the bars represent cases of severe (grade 3-5) hepatitis, and hatched portions of the bars represent moderate (grade 2) hepatitis at least possibly associated with isoniazid. The line graph represents participants continuing to receive IPT. From the 1,006 initiating 36-mo IPT, three participants were lost to follow-up, and 91 withdrew before the end of the trial. See Figure 1 legend for expansion of abbreviation. CHEST  , DOI: ( /chest ) Copyright © 2015 The American College of Chest Physicians Terms and Conditions

4 Figure 3 – Outcomes among representative participants with moderate (grade 2) hepatitis among adults infected with HIV receiving isoniazid by month. Color-filled rows for INH and ART indicate months when INH or ART were received by the participant. A, Elevated serum transaminase resolved with INH continued, no ART initiated. B, Elevated serum transaminase resolved with INH continued, ART initiated. C, Elevated serum transaminase persisted with INH continued. D, Elevated serum transaminase persisted despite INH discontinuation. E, Elevated serum transaminase worsened resulting in discontinuation of INH. INH = isoniazid; PMTCT = single antiretroviral drug for the prevention of mother-to-child transmission of HIV. See Figure 1 legend for expansion of other abbreviations. CHEST  , DOI: ( /chest ) Copyright © 2015 The American College of Chest Physicians Terms and Conditions


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