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Treatment of latent tuberculosis infection (LTBI) is an important tuberculosis prevention and control strategy, especially in high-resource countries. The effectiveness of LTBI treatment, which usually consists of isoniazid (also known as isonicotinylhydrazine (INH)) for 6–9 months, is limited by poor patient adherence because of long treatment duration and adverse effects. The most common serious adverse effect of INH is hepatotoxicity, which increases with age and can be fatal.1 A meta-analysis of six studies found that the pooled rate of INH-associated hepatotoxicity was 0.6%.2
Smith and colleagues conducted a population-based evaluation of serious adverse events of LTBI treatment in Quebec, Canada. Data were abstracted from administrative databases of the government managed-care health insurer (covers more than 99% of permanent residents). The authors compared an LTBI treatment cohort consisting of persons in the health insurance database who received either …
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