TY - JOUR T1 - Liver injury in treatment of latent tuberculosis infection - is the age cut-off for treatment justified? JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - 1900 AU - Alison L. Gill AU - Su Ann Leong AU - Toby G.D. Capstick AU - John P. Watson Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/1900.abstract N2 - BackgroundScreening for latent tuberculosis infection (LTBI) is recommended for close contacts of active tuberculosis (TB) cases, new entrants from high incidence countries, and prior to anti-TNF treatment. NICE recommends chemoprophylaxis to reduce progression to active TB for patients under the age of 35, and for high-risk patients above this age. We hypothesised that rates of liver dysfunction are low and not strongly related to age, which would favour chemoprophylaxis in older patients.MethodsWe retrospectively identified all patients treated for LTBI in Leeds during 2012 from our pharmacy database. We recorded LFTs at baseline and during treatment. We identified all patients with evidence of liver dysfunction during treatment, defined as symptomatic and >3x upper limit of normal (ULN), or >5xULN. We compared rates of liver dysfunction in the under-35 and over-35 groups.Results112 patients received chemoprophylaxis during 2012. Of these, 66 were aged under 35 years. Four patients (3.6%) developed deranged LFTs (ALT>3xULN) during treatment (three over-35). Of these, two (1.8%) developed ALT>5xULN (one from each age group) and required cessation or interruption of treatment. There was no significant difference between the under-35 and over-35 groups for either level of derangement.ConclusionThis study shows little difference in hepatotoxicity between those below and above the 35-year age cut-off. This data supports chemoprophylaxis at higher ages. Further work is needed into other predictors of LFT derangement, including co-morbidities, other medications and genotypic factors. We plan to extend this analysis to all patients treated from 2007 onwards. ER -