ISONIAZID AND THE HEPATITIS B CARRIER STATE IN SOUTHEAST ASIANS IN PHILADELPHIA.

Format:

Book

Thesis/Dissertation

Author/Creator:

MCGLYNN, KATHERINE ANN.

Contributor:

University of Pennsylvania.

Subjects (All):

Public health.

0573.

Local Subjects:

0573.

Physical Description:

143 pages

Contained In:

Dissertation Abstracts International 46-01B.

System Details:

Mode of access: World Wide Web.

text file

Summary:

Isoniazid (INH) is a bactericidal drug which is prescribed for tuberculosis prophylaxis. Among its adverse effects is that of hepatotoxicity. Between ten and twenty percent of persons exposed to INH show evidence of liver damage in the form of elevated serum transaminase levels. Chronic carriers of the hepatitis B virus (HBV) also suffer persistent liver damage and thus have elevated transaminase levels. It was the purpose of this research to determine whether the combined effects of these two factors, INH and HBV infection, would result in greater liver damage than results from either factor alone. The hypothesis was that hepatitis carriers, exposed to INH, would have higher transaminase levels than would carriers not exposed to the drug, or than non-carriers, regardless of exposure.

This hypothesis was tested, using two designs, in 2282 members of the southeast Asian population of Philadelphia. The cross-sectional research, using all study participants, examined alanine aminotransferase (ALT) levels, partitioned by INH and HBV status. The longitudinal research followed a matched group of HBV carriers and non-carriers to assess the effect of INH exposure on ALT level.

The combined results demonstrated that HBV carriers had higher mean ALT levels than non-carriers. Both HBV carriers and non-carriers had higher ALT levels in the first two months of INH prophylaxis than either prior to therapy or in the final ten months of therapy. However, HBV carriers who had not received INH because they had a negative tuberculin skin test, had the highest mean ALT level of any group. There was no evidence of a combined effect of INH and HBV on ALT level. Therefore, chronic HBV infection was not a contraindication to INH prophylaxis.

The finding that HBV carriers with a negative tuberculine test had the highest ALT level of any group, prompted further study of the basis for this observation. Our analysis revealed an age-related, inverse association between delayed hypersensitivity to tuberculin and hepatitis B e antigen (a serum marker of HBV replication). Several possible explanations for this association are discussed.

Notes:

Source: Dissertation Abstracts International, Volume: 46-01, Section: B, page: 0131.

Thesis (Ph.D.)--University of Pennsylvania, 1984.

Local Notes:

School code: 0175.

Access Restriction:

Restricted for use by site license.