Isoniazid in Children – Any Rationale for Post Isoniazid Liver Function Test?

Isoniazid (INH) therapy remains the treatment of choice in latent tuberculosis infection (LTBI). However, drug-induced liver injury (DILI) is a known adverse effect of isoniazid. Serum transaminase elevation occurs in about 10% of children receiving INH monotherapy. Drug-induced liver injury can range from asymptomatic increase of aminotransferase to severe liver injury, or in some cases hepatic failure. Even though INH-induced liver injury has been known and extensively studied, its underlying mechanisms are still not fully understood. The liver injury comprises hepatotoxicity and a rarer form of hepatitis hypersensitive allergic reaction. Since the facility to do liver function (LFT) is widely available, monitoring liver function while on INH therapy is the wisest way of monitoring acute liver injury (ATLI).