Isoniazid Hepatotoxicity Fact or Fantasy

N. M. Kester, MD
JAMA. 1971;217(5):699. doi:10.1001/jama.1971.03190050155026.
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To the Editor.—  In November 1970, a series of reports emanating from Washington, DC, and from the Communicable Disease Center in Atlanta implicated isoniazid in the deaths of two persons from acute liver failure.Some 2,300 positive tuberculin reactors had been placed on preventive treatment with isoniazid in the national capitol following an outbreak of tuberculosis there. The two deaths which occurred could not definitely be traced to any particular cause, but the news media and television reports very definitely incriminated isoniazid as the cause. Isoniazid was introduced in the treatment of tuberculosis about 20 years ago, and has been given to more than 100 million patients throughout the world. It has been considered an almost perfect drug, and no previous deaths from hepatotoxicity have been reported until this incident. Since the use of isoniazid in preventive treatment is the only means of forestalling the development of active tuberculosis in


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