rifampin and Hepatitis-B

The present study is designed to conduct, the analysis on the curative effect of Lamivudine in treating liver function lesion caused by hepatitis B combined anti-TB drugs. The 4200 patients who have been treated for hepatitis B combined with pulmonary TB in 8 different hospitals from Feb 2014 to Feb 2016 were selected as research objects. They were randomly divided into control group and observation group, each containing 2100 patients. In control group, patients were applied with conventional Anti-TB therapy and liver-protecting therapy; while in observation group, patients were applied with lamivudine in addition to conventional therapies. The variations of liver functions of both groups before and after therapies were observed. After treatment, the liver function lesions of patients in observation group were significantly lower than that in control group; moreover, the drug withdrawal rates of patients in control group were significantly higher. There was statistical difference between both group, P<0.05. In the process of treating patients with liver function lesions caused by hepatitis B combined with anti-TB, applying Lamivudine on the basis of conventional liver protection therapy and anti-TB therapy can effectively inhibit HBV replication, and prevent liver disease from getting worse, so as to reduce the liver function lesions in treating patients with hepatitis B combined with anti-TB and accelerate rehabilitation.

Topics: Adult; Aged; Antitubercular Agents; Antiviral Agents; Drug Therapy, Combination; Female; Hepatitis B; Humans; Isoniazid; Lamivudine; Liver; Liver Function Tests; Male; Middle Aged; Rifampin; Treatment Outcome; Tuberculosis; Withholding Treatment; Young Adult

In 2015, 4062 unaccompanied minor refugees were registered in Berlin, Germany. According to national policies, basic clinical examination and tuberculosis (TB) screening is a prerequisite to admission to permanent accommodation and schooling for every refugee. This article evaluates the use of an interferon-γ-release-assay (IGRA) during the initial examination and TB screening of 970 unaccompanied minor refugees.. IGRA test were obtained during TB screening for 301 (31.0%) of 970 adolescents not previously screened for TB. Positive IGRA results were obtained in 13.9% (42/301). Most of the 42 IGRA-positive refugees originated from Afghanistan or Syria (n?20 and 10 respectively). Two IGRA-positive adolescents were lost to follow-up, 2 were diagnosed with TB and the remaining 38 diagnosed with latent TB infection (LTBI). Demographic features of the 40 patients with positive IGRA result were as follows: 39 male, median age 16.8 years (IQR 16.0-17.2y), none meeting underweight criteria (median BMI 21.3kg/m2). On initial chest X-ray 2/40 participants had signs of active TB, while in 38 active disease was excluded and the diagnosis of latent TB infection (LTBI) made. Active hepatitis B-co-infection was diagnosed in 3/38 patients. All patients with LTBI received Isoniazid and Rifampicin for 3 months without occurrence of severe adverse events. The most frequently observed side effect was transient upper abdominal pain (n = 5). Asymptomatic elevation of liver transaminases was seen in 2 patients. 29 patients completed treatment with no signs of TB disease at the end of chemoprevention and 9 were lost to follow up.. Screening for TB infection in minor refugees was feasible in our setting with a relatively high rate of TB infection detected. Chemopreventive treatment was tolerated well regardless of underlying hepatitis-B-status. Minor refugees migrating to Germany should be screened for TB infection, instead of TB disease only, regardless of the background TB incidence.

Topics: Adolescent; Berlin; Chemoprevention; Female; Germany; Hepatitis B; Humans; Isoniazid; Latent Tuberculosis; Male; Mass Screening; Minors; Refugees; Rifampin; Tuberculosis

Topics: Antimicrobial Cationic Peptides; Cathelicidins; Guanine; Helicobacter Infections; Hepatitis B; Humans; Isoniazid; Rifampin; Tuberculosis, Multidrug-Resistant

Topics: Antitubercular Agents; Antiviral Agents; Drug Therapy, Combination; Hepatitis B; Humans; Isoniazid; Lamivudine; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

To determine whether inactive hepatitis B surface antigen (HBsAg) carriers are at a higher risk of drug-induced hepatotoxicity than control subjects during antituberculosis treatment with standard short-course regimens of isoniazid, rifampin, ethambutol, and/or pyrazinamide.. Retrospective case-control study.. Tertiary university medical center.. One hundred ten inactive HBsAg carriers with newly diagnosed active tuberculosis who had been treated with isoniazid, rifampin, ethambutol, and/or pyrazinamide were included in the study population. Inactive HBsAg carriers were defined as follows: (1) positive for HbsAg; (2) negative for hepatitis B e antigen (HBeAg), positive for antibody to HBeAg; (3) < 10(5) copies per mL of serum hepatitis B virus DNA; and (4) normal pretreatment aspartate aminotransferase (AST)/alanine aminotransferase (ALT) levels. Ninety-seven HBsAg-negative patients who received standard antituberculosis medication were selected as control subjects.. The baseline characteristics of the 110 inactive HBsAg carriers were similar to those of the 97 noncarriers. A total of 85% of persons in both groups had received an initial treatment regimen that included pyrazinamide. Thirty-eight inactive HBsAg carriers (35%) and 19 control subjects (20%) exhibited elevated liver enzyme levels during antituberculosis treatment (p = 0.016). Drug-induced hepatotoxicity, which was defined as a liver transaminase level of >/= 120 IU/L, occurred more frequently in HBsAg carriers (9 of 110 carriers; 8%) than in control subjects (4 of 97 control subjects; 4%), although this was not a statistically significant discrepancy (p = 0.230). More importantly, HBsAg carriers (n = 9; 8%) who received antituberculosis therapy evidenced a higher proportion of moderate-to-severe drug-induced hepatotoxicity when compared with the control subjects (n = 2; 2%; p = 0.05). Isoniazid and rifampin were reintroduced as therapy after AST/ALT levels returned to baseline values in 10 patients (6 HBsAg carriers and 4 control subjects) among the 13 patients exhibiting drug-induced hepatotoxicity, and these retrials proved to be successful in 7 patients (5 HBsAg carriers and 2 control subjects).. Tuberculosis treatment in HBsAg-positive and HBeAg-negative inactive carriers could be pursued in the usual manner, using standard short-course regimens of isoniazid, rifampin, ethambutol, and/or pyrazinamide, with the condition that monthly liver function tests are performed.

Topics: Adult; Antitubercular Agents; Carrier State; Case-Control Studies; Chemical and Drug Induced Liver Injury; Ethambutol; Female; Hepatitis B; Hepatitis B Surface Antigens; Humans; Incidence; Isoniazid; Male; Pyrazinamide; Retrospective Studies; Rifampin; Risk Factors

Topics: Adult; Antitubercular Agents; Cholestasis, Intrahepatic; Diagnostic Errors; Hepatitis B; Hepatitis C; HIV Infections; Humans; Isoniazid; Male; Medicine in the Arts; Mercury Poisoning; Pyrazinamide; Rifampin; Television; Tuberculosis

An alternative regimen for the treatment of latent tuberculosis infection is 2 months of rifampin and pyrazinamide, but some patients have died of hepatitis associated with this therapy. One hundred fourteen patients received rifampin/pyrazinamide in Wake County, North Carolina, between December 1999 and May 2002; 60.5% of these patients were homeless, and at least 17% drank alcohol to excess. Seventy-seven patients (67.5%) completed a full 2-month course. Nine patients had a history of viral hepatitis or chronic liver disease. Four of 114 (3.5%; 95% confidence interval, 1.0-8.7%) patients developed hepatitis on therapy, and another two had symptoms consistent with hepatitis but did not report for laboratory testing (total confirmed plus suspected hepatitis rate 5.3%; 95% confidence interval, 2.0-11.1%). No patient who developed hepatitis had a history of viral hepatitis or liver disease, and none had been previously treated with isoniazid. No patients died or were hospitalized due to drug side effects. Rifampin/pyrazinamide was associated with a significantly higher rate of hepatitis than previously described with isoniazid therapy for latent tuberculosis but resulted in a high completion rate. The rifampin/pyrazinamide regimen for latent tuberculosis infection may be useful for high-risk, traditionally nonadherent patient groups, but careful monitoring for toxicity is required.

Topics: Adolescent; Adult; Aged; Alcoholism; Antibiotics, Antitubercular; Antitubercular Agents; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Cohort Studies; Comorbidity; Drug Administration Schedule; Drug Monitoring; Drug Therapy, Combination; Female; Hepatitis B; Hepatitis C; Humans; Ill-Housed Persons; Infant; Liver Diseases; Male; Middle Aged; North Carolina; Pyrazinamide; Rifampin; Safety; Treatment Outcome; Tuberculosis

The bioassay- and spectroscopic-guided fractionation of the antimalarial extract from a Jamaican sponge, Plakortis sp., resulted in the isolation of three metabolites. The previously reported bromoaromatic filiformin (1) was obtained from our sample of Plakortis sp., and the potential origins of this compound are discussed. The peroxide-containing metabolite, plakortide F (2), is a more typical Plakortis metabolite and was shown to exhibit significant activity against Plasmodium falciparum in vitro. The isolation, structure, and bioactivity of a new lactone, plakortone G (3), are also reported.

Topics: Animals; Antimalarials; Bromobenzenes; Chromatography, High Pressure Liquid; Colonic Neoplasms; Dioxanes; Gas Chromatography-Mass Spectrometry; Hepatitis B; HIV; Humans; Jamaica; Lactones; Leukemia P388; Lung Neoplasms; Mice; Molecular Structure; Mycobacterium tuberculosis; Neoplasms, Unknown Primary; Nuclear Magnetic Resonance, Biomolecular; Plasmodium berghei; Plasmodium falciparum; Porifera; Spectrometry, Mass, Electrospray Ionization; Tumor Cells, Cultured

Department of Chest Diseases, Gazi University Faculty of Medicine and Atatürk Chest Diseases Hospital, Ankara, Turkey.. The primary purpose of this study was to assess the contributory role of viral hepatitis in antituberculosis drug hepatotoxicity.. Serologic markers for viral hepatitis were studied in 57 patients who developed acute hepatitis during antituberculosis therapy with rifampicin and isoniazid.. Among 705 adult tuberculous patients, 57 (8.1%) developed acute hepatitis during therapy with rifampicin and isoniazid. Serologic markers confirmed the presence of hepatitis B in 6 (10.5%) and hepatitis C in 4 (7%) of the 57 patients. Acute hepatitis A was not diagnosed in any of the patients.. Hepatitis occurring during antituberculosis therapy may not be drug-induced in all patients. Apart from the other factors mentioned above the endemicity of viral hepatitis in developing countries could be responsible for the higher incidence of antituberculosis-drug hepatitis.

Topics: Acute Disease; Adolescent; Adult; Chemical and Drug Induced Liver Injury; Diagnosis, Differential; Drug Therapy, Combination; Female; Hepatitis B; Hepatitis C; Hepatitis, Viral, Human; Humans; Isoniazid; Male; Middle Aged; Pyrazinamide; Rifampin

Serologic markers for hepatitis viruses were studied in 40 children who developed acute hepatitis during antituberculosis therapy with rifampin and isoniazid, with the aim of assessing the contributory role of these viruses toward producing hepatic injury. Hepatitis A and B were confirmed in 7.5 and 35% patients, respectively, by IgM antibodies. Epidemiologic evidence suggested the possibility of non-A, non-B hepatitis in at least a few of the remaining 23 children. Hepatitis B was seen more often in children with severe tubercular disease (72%) and was largely (92.8%) parenterally transmitted. The study highlights that the endemicity of viral hepatitis in developing countries, among other factors, could also be responsible for the reported higher incidence of hepatotoxicity from developing countries and also for the increased risk of hepatotoxicity seen in severe tubercular disease.

Topics: Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Female; Hepatitis A; Hepatitis B; Hepatitis C; Humans; Infant; Isoniazid; Liver; Male; Rifampin; Tuberculosis

From January 1984-December 1987, 1783 patients received combination therapy of isoniazid, rifampin, and ethambutol for the control of tuberculosis. Forty-two developed symptomatic hepatitis during the period of treatment. Fifteen were hepatitis B virus carriers, and the remaining 27 were noncarriers. The peak serum transaminase and bilirubin levels were higher in carriers. Seven carriers died of fulminant or subacute hepatic failure, and only 1 noncarrier died. Eleven carriers had detectable serum hepatitis B virus deoxyribonucleic acid during the acute stage of hepatitis. The roles of isoniazid-rifampin combination therapy and hepatitis B virus in the adverse outcomes of carriers were discussed.

Topics: Carrier State; Chemical and Drug Induced Liver Injury; Drug Therapy, Combination; Ethambutol; Female; Hepatitis B; Humans; Isoniazid; Male; Middle Aged; Rifampin; Tuberculosis, Pulmonary

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.

Topics: Adolescent; Africa; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Drug Combinations; Female; Hepatitis B; Humans; Infant; Isoniazid; Liver; Male; Nutrition Disorders; Rifampin; Transaminases; Tuberculosis, Pulmonary

Topics: Adult; Blood Transfusion; Ethionamide; Hepatitis B; Humans; Liver; Liver Function Tests; Postoperative Complications; Rifampin; Time Factors; Tuberculosis, Pulmonary