Evaluation of hepatotoxicity in elderly with HIV/AIDS using isoniazid

Abstract

Introduction: The aging of the population becomes notorious from the twentieth century reaching several countries of the world. Data from the 2019 Epidemiological Bulletin of the Ministry of Health report an increase in the incidence of AIDS among elderly males in the period 2008 to 2018 of 9.7% and a 5% reduction among women. The impairment of the immune system favors the emergence of diseases considered opportunistic and Tuberculosis (TB) is the leading cause of death among individuals with AIDS. One of the measures to prevent TB/HIV co-infection in young and elderly adults, according to the World Health Organization, is treatment with the drug isoniazid, which aims to reduce the risk of illness from Mycobacterium tuberculosis and consequently the manifestation of TB. Regarding isoniazid, hepatotoxicity is a potentially serious adverse reaction that can even result in death. Objective: To evaluate the risk of hepatotoxicity to the use of isoniazid measured through laboratory test results through liver enzymes. METHOD: Descriptive and analytical retrospective cross-sectional study with elderly patients with HIV/AIDS using isoniazid in a specialized HIV/AIDS Service from 2008 to 2011. Laboratory results of hepatic transaminases (AST and ALT) and glutaryltranferase range from a secondary database at 3 specific moments (pre-treatment, concomitant treatment and post-treatment with isoniazid) and subjects’ characteristics (age, gender, time of HIV infection) were analyzed. The data were analyzed in statistical program SPSS 20. Result: We analyzed 12 subjects aged 60 years or older, 75% (9) men, mean age 63 years and 25% (3) women, mean age 68 years. The subjects had an average of 15 years of HIV infection. There was an increase of 20.9% in AST, and 11.5% in the Range Gutamiltransferase concomitant with the treatment in relation to the pre-treatment values. Conclusion: Laboratory results for the use of isoniazid showed a slight hepatotoxicity elevation without the need to discontinuation of preventive treatment with isoniazid, however, follow-up by a multidisciplinary and pharmaceutical team is necessary.