{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:57:56Z","timestamp":1784782676260,"version":"3.55.0"},"reference-count":31,"publisher":"European Respiratory Society (ERS)","issue":"3","license":[{"start":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T00:00:00Z","timestamp":1579824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.ersjournals.com\/user-licence"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2020,1,10]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p>Clinical trials suggest less hepatotoxicity and better adherence with 4\u2005months rifampin (4R)<jats:italic>versus<\/jats:italic>9\u2005months isoniazid (9H) for treating latent tuberculosis infection (LTBI). Our objectives were to compare frequencies of severe hepatic adverse events and treatment completion, and direct health system costs of LTBI regimens 4R and 9H, in the general population of the province of Quebec, Canada, using provincial health administrative data.<\/jats:p><jats:p>Our retrospective cohort included all patients starting rifampin or isoniazid regimens between 2003 and 2007. We estimated hepatotoxicity from hospitalisation records, treatment completion from community pharmacy records and direct costs from billing records and fee schedules. We compared rifampin to isoniazid using logistic (hepatotoxicity), log-binomial (completion), and gamma (costs) regression, with adjustment for age, co-morbidities and other confounders.<\/jats:p><jats:p>10\u200a559 individuals started LTBI treatment (9684 isoniazid; 875 rifampin). Rifampin patients were older with more baseline co-morbidities. Severe hepatotoxicity risk was higher with isoniazid (n=15) than rifampin (n=1), adjusted OR=2.3 (95% CI: 0.3\u201316.1); there were two liver transplants and one death with isoniazid and none with rifampin. Overall, patients without co-morbidities had lower hepatotoxicity risk (0.1%<jats:italic>versus<\/jats:italic>1.0%). 4R completion (53.5%) was higher than 9H (36.9%), adjusted RR=1.5 (95% CI: 1.3\u20131.7). Mean costs per patient were lower for rifampin than isoniazid: adjusted cost ratio=0.7 (95% CI: 0.5\u20130.9).<\/jats:p><jats:p>Risk of severe hepatotoxicity and direct costs were lower, and completion was higher, for 4R than 9H, after adjustment for age and co-morbidities. Severe hepatotoxicity resulted in death or liver transplant in three patients receiving 9H, compared with no patients receiving 4R.<\/jats:p>","DOI":"10.1183\/13993003.02048-2019","type":"journal-article","created":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T17:16:46Z","timestamp":1579886206000},"page":"1902048","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":47,"title":["Treatment with isoniazid or rifampin for latent tuberculosis infection: population-based study of hepatotoxicity, completion and costs"],"prefix":"10.1183","volume":"55","author":[{"given":"Lisa A.","family":"Ronald","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Mark","family":"FitzGerald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Bartlett-Esquilant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3354-1159","authenticated-orcid":false,"given":"Kevin","family":"Schwartzman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Benedetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Boivin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"Menzies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2020,1,24]]},"reference":[{"key":"2024102101213643000_55.3.1902048.1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00214014"},{"key":"2024102101213643000_55.3.1902048.2","first-page":"1","article-title":"Targeted tuberculin testing and treatment of latent tuberculosis infection. American Thoracic Society","volume":"49","year":"2000","journal-title":"MMWR Recomm Rep"},{"key":"2024102101213643000_55.3.1902048.3","unstructured":"Public Health Agency of Canada and Canadian Lung Association\/Canadian Thoracic Society. Canadian Tuberculosis Standards, 7th Edition (2014). www.canada.ca\/en\/public-health\/services\/infectious-diseases\/canadian-tuberculosis-standards-7th-edition.html."},{"key":"2024102101213643000_55.3.1902048.4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00203811"},{"key":"2024102101213643000_55.3.1902048.5","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200404-478OC"},{"key":"2024102101213643000_55.3.1902048.6","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-149-10-200811180-00003"},{"key":"2024102101213643000_55.3.1902048.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1714283"},{"key":"2024102101213643000_55.3.1902048.8","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.125054"},{"key":"2024102101213643000_55.3.1902048.9","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.6.1712"},{"key":"2024102101213643000_55.3.1902048.10","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.17.1863"},{"key":"2024102101213643000_55.3.1902048.11","doi-asserted-by":"publisher","DOI":"10.1086\/505398"},{"key":"2024102101213643000_55.3.1902048.12","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2011.13240.eCollection 2011"},{"key":"2024102101213643000_55.3.1902048.13","doi-asserted-by":"publisher","DOI":"10.1086\/600394"},{"key":"2024102101213643000_55.3.1902048.14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7456.44"},{"key":"2024102101213643000_55.3.1902048.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2007.00496.x"},{"key":"2024102101213643000_55.3.1902048.16","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-7-159"},{"key":"2024102101213643000_55.3.1902048.17","unstructured":"McGill University Health Centre (MUHC). Estimated average costs of inpatient days in McGill University Health Centre (MUHC) hospital. Personal communication (September 2011). 2011."},{"key":"2024102101213643000_55.3.1902048.18","unstructured":"Sant\u00e9 et Services sociaux Qu\u00e9bec. Normes et Practiques de Gestion Circulaire. Tarifs des services rendus en extreme: Listes des taux applicables au 1er mai 2011. Annexe \u00e0 la circulaire 2011-016 (03.01.42.19). Published 2011-05-01. http:\/\/msssa4.msss.gouv.qc.ca\/fr\/document\/d26ngest.nsf\/listNum?OpenView"},{"key":"2024102101213643000_55.3.1902048.19","first-page":"1235","article-title":"Adherence to treatment for latent tuberculosis infection: systematic review of studies in the US and Canada","volume":"12","author":"Hirsch-Moverman","year":"2008","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024102101213643000_55.3.1902048.20","first-page":"1449","article-title":"Evaluating the role of primary care physicians in the treatment of latent tuberculosis: a population study","volume":"18","author":"Rubinowicz","year":"2014","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024102101213643000_55.3.1902048.21","first-page":"489865","article-title":"Psychiatric morbidity and other factors affecting treatment adherence in pulmonary tuberculosis patients","volume":"2013","author":"Pachi","year":"2013","journal-title":"Tuberc Res Treat"},{"key":"2024102101213643000_55.3.1902048.22","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"2024102101213643000_55.3.1902048.23","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg074"},{"key":"2024102101213643000_55.3.1902048.24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2006.00610.x"},{"key":"2024102101213643000_55.3.1902048.25","doi-asserted-by":"crossref","first-page":"e292","DOI":"10.1016\/j.ijid.2009.05.007","article-title":"Adherence to treatment of latent tuberculosis infection in a clinical population in New York City","volume":"14","author":"Li","year":"2010","journal-title":"Int J Infect Dis"},{"key":"2024102101213643000_55.3.1902048.26","first-page":"551","article-title":"Factors associated with treatment adherence in a randomised trial of latent tuberculosis infection treatment","volume":"14","author":"Trajman","year":"2010","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024102101213643000_55.3.1902048.27","doi-asserted-by":"crossref","unstructured":"Horsburgh CR, Jr. , Goldberg S , Bethel J , et al. Latent TB Infection Treatment Acceptance and Completion in the United States and Canada. Chest; 137: 401\u2013409. doi:10.1378\/chest.09-0394","DOI":"10.1378\/chest.09-0394"},{"key":"2024102101213643000_55.3.1902048.28","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.10357"},{"key":"2024102101213643000_55.3.1902048.29","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/145.2_Pt_1.494"},{"key":"2024102101213643000_55.3.1902048.30","first-page":"991","article-title":"Isoniazid-related hepatitis: a U.S. Public Health Service cooperative surveillance study","volume":"117","author":"Kopanoff","year":"1978","journal-title":"Am Rev Respir Dis"},{"key":"2024102101213643000_55.3.1902048.31","first-page":"1374","article-title":"Age-related risk of hepatotoxicity in the treatment of latent tuberculosis infection: a systematic review","volume":"14","author":"Kunst","year":"2010","journal-title":"Int J Tuberc Lung Dis"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/13993003.02048-2019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T07:28:21Z","timestamp":1740382101000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/13993003.02048-2019"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,24]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,3,20]]},"published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1183\/13993003.02048-2019"],"URL":"https:\/\/doi.org\/10.1183\/13993003.02048-2019","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,24]]}}}