I need to talk to an expert on the liver. I have TB.

[A5]

Originally posted by: ICRS
I really need to get a TB test, but haven't found a place to get it done. I was apparently "exposed" to TB a few years back and received a notice from the health department urging me to get tested.

Seriously? Any health clinic, hospital, or general practitioner should be able to administer a skin test.

 

[Gibsons]

OP - the risks from isoniazid are pretty small if you're continually monitored and you don't have any other risk factors (you probably don't). The liver is pretty cool in that it's able to reverse a lot of damage. Otoh, there's a small chance that your dormant infection could become actual disease, and that's no picnic at all. You'll absolutely have to take the drugs then anyway.

IF it were me, it's a no brainer, quit drinking for a while, take the drugs.

Remember the rules:

The Lord loves a working man, don't trust whitey, see a doctor and get rid of it.

 

[moshquerade]

Originally posted by: Gibsons
OP - the risks from isoniazid are pretty small if you're continually monitored and you don't have any other risk factors (you probably don't). The liver is pretty cool in that it's able to reverse a lot of damage. Otoh, there's a small chance that your dormant infection could become actual disease, and that's no picnic at all. You'll absolutely have to take the drugs then anyway.

IF it were me, it's a no brainer, quit drinking for a while, take the drugs.

Remember the rules:

The Lord loves a working man, don't trust whitey, see a doctor and get rid of it.

Whose rules are those?

 

[Gibsons]

Originally posted by: moshquerade

Originally posted by: Gibsons
OP - the risks from isoniazid are pretty small if you're continually monitored and you don't have any other risk factors (you probably don't). The liver is pretty cool in that it's able to reverse a lot of damage. Otoh, there's a small chance that your dormant infection could become actual disease, and that's no picnic at all. You'll absolutely have to take the drugs then anyway.

IF it were me, it's a no brainer, quit drinking for a while, take the drugs.

Remember the rules:

The Lord loves a working man, don't trust whitey, see a doctor and get rid of it.

Whose rules are those?

Navin R. Johnson

 

[moshquerade]

Originally posted by: Gibsons

Originally posted by: moshquerade

Originally posted by: Gibsons
OP - the risks from isoniazid are pretty small if you're continually monitored and you don't have any other risk factors (you probably don't). The liver is pretty cool in that it's able to reverse a lot of damage. Otoh, there's a small chance that your dormant infection could become actual disease, and that's no picnic at all. You'll absolutely have to take the drugs then anyway.

IF it were me, it's a no brainer, quit drinking for a while, take the drugs.

Remember the rules:

The Lord loves a working man, don't trust whitey, see a doctor and get rid of it.

Whose rules are those?

Navin R. Johnson

special purpose?

 

[drum]

Originally posted by: Gibsons

Originally posted by: moshquerade

Originally posted by: Gibsons
OP - the risks from isoniazid are pretty small if you're continually monitored and you don't have any other risk factors (you probably don't). The liver is pretty cool in that it's able to reverse a lot of damage. Otoh, there's a small chance that your dormant infection could become actual disease, and that's no picnic at all. You'll absolutely have to take the drugs then anyway.

IF it were me, it's a no brainer, quit drinking for a while, take the drugs.

Remember the rules:

The Lord loves a working man, don't trust whitey, see a doctor and get rid of it.

Whose rules are those?

Navin R. Johnson

You Jerk...

 

[Pepsei]

nothing to worry about, next step is a chest x-ray.

all it means is that you've been exposed to TB, and have antibodies in your system. and don't ever take the skin test again, you'll always test positive from now on. (so you can skip right to the x-ray and save some time and money in the future)

edit: why do you need a liver expert? were you tested positive to have hep B antibodies as well?

 

[Gibsons]

Originally posted by: Pepsei
nothing to worry about, next step is a chest x-ray.

all it means is that you've been exposed to TB, and have antibodies in your system. and don't ever take the skin test again, you'll always test positive from now on. (so you can skip right to the x-ray and save some time and money in the future)

edit: why do you need a liver expert? were you tested positive to have hep B antibodies as well?

He's worried about hepatotoxic side effects of isoniazid.

 

[pravi333]

Originally posted by: Turin39789
hope you have insurance

no need the government treats you for free.

 

[Born2bwire]

You've got the consumption mate! The crushers will be coming to lock you up like Typhoid Mary.

 

[PlasmaBomb]

Originally posted by: se7en
You should call whoever administered the PPD and they will tell you what you should do.

This

Its only common side-effect is peripheral neuropathy which is more likely to occur where there are pre-existing risk factors such as diabetes, alcohol dependence, chronic renal failure, malnutrition and HIV infection. In these circumstances pyridoxine 10 mg daily (or 20 mg daily if suitable product not available) should be given prophylactically from the start of treatment.

Other side-effects such as hepatitis are rare.

Since isoniazid, rifampicin and pyrazinamide are associated with liver toxicity, hepatic function should be checked before treatment with these drugs. Those with pre-existing liver disease or alcohol dependence should have frequent checks particularly in the first 2 months.

*disclaimer* not a doctor - consult your own doctor or hospital.

Hope that helps put your mind at rest

 

[dullard]

PPD tests are wildly inaccurate. I know for a fact that it only catches 40% of the people with TB, that is, if you have TB only 40% of the time will the PPD test say you have it.

Unfortunately, I don't know the reverse data off the top of my head (ie if the PPD test says you have it, what is the percent of the time that you don't actually have TB). All that a positive PPD test means is that at some point you were exposed to the mycobacterium genus (the group that includes tuberculosis). Thus, you may have active or latent TB, or you may have had a BCG vaccine (common outside the US), or you might have one of the many other mycobacterium members. You just don't know with a PPD test.

About 1/3rd of the world tests positive for latent TB. Thus, it is quite common for someone to be PPD positive. It doesn't mean that you are sick or that you have that much to worry about. But if you are PPD positive AND you are showing the signs of active disease, then you should worry and seek treatment.

I'd love to get ahold of a sputum sample of yours and run it through some of the tests that I'm developing. But I know that the regulations wouldn't allow for that. I can only work with samples that cannot easilly be linked back to specific individuals.

Unfortunately, I know little about the treatment side of TB - I work solely on the diagnostic tests. Isoniazid has about a 0.5% chance of side effects if I remember correctly. So, the chance of developing liver problems is there but small.

But like others have said above, if you start taking a cocktail of drugs, please take them all every day for the entire time you are prescribed. This is to help save the lives of millions of people who will die from MDR-TB or XDR-TB (the multidrug-resistant or extremely drug-resistant forms). Heck, if you don't care about them, then care about the small chance that you might develop one of those resistant forms if you don't take your medications. If you are worried about isoniazid, you'll be damn worried about the second line of drugs. They require injections and hospital stays for months if you can even live that long.

 

[Mo0o]

Originally posted by: dullard
PPD tests are wildly inaccurate. I know for a fact that it only catches 40% of the people with TB, that is, if you have TB only 40% of the time will the PPD test say you have it.

Unfortunately, I don't know the reverse data off the top of my head (ie if the PPD test says you have it, what is the percent of the time that you don't actually have TB). All that a positive PPD test means is that at some point you were exposed to the mycobacterium genus (the group that includes tuberculosis). Thus, you may have active or latent TB, or you may have had a BCG vaccine (common outside the US), or you might have one of the many other mycobacterium members. You just don't know with a PPD test.

About 1/3rd of the world tests positive for latent TB. Thus, it is quite common for someone to be PPD positive. It doesn't mean that you are sick or that you have that much to worry about. But if you are PPD positive AND you are showing the signs of active disease, then you should worry and seek treatment.

I'd love to get ahold of a sputum sample of yours and run it through some of the tests that I'm developing. But I know that the regulations wouldn't allow for that. I can only work with samples that cannot easilly be linked back to specific individuals.

Unfortunately, I know little about the treatment side of TB - I work solely on the diagnostic tests. Isoniazid has about a 0.5% chance of side effects if I remember correctly. So, the chance of developing liver problems is there but small.

But like others have said above, if you start taking a cocktail of drugs, please take them all every day for the entire time you are prescribed. This is to help save the lives of millions of people who will die from MDR-TB or XDR-TB (the multidrug-resistant or extremely drug-resistant forms). Heck, if you don't care about them, then care about the small chance that you might develop one of those resistant forms if you don't take your medications. If you are worried about isoniazid, you'll be damn worried about the second line of drugs. They require injections and hospital stays for months if you can even live that long.

From what I've read, BCG shouldn't come up pos after about 5 years or so. I use to come up pos and my old family physician just assumed it was the BCG but after I switched fam docs, the new one said that wasn't the case. I went on 2 6 month courses of INH (because I was an idiot and had poor compliance during the first course) and haven't come up PPD negative since then.

You could always ratchet up the sensitivity by lowering the induration diameter that you consider positive (what they do w/ healthcare workers). Just makes the test a lot less specific.

 

[Iron Woode]

Originally posted by: Capt Caveman

Originally posted by: CatchPhrase
I know there are some doctors here because I have talked to them before?

No real doctors just ATOT internet doctors.

but I did stay at a Holiday Inn.

 

[Mark R]

Originally posted by: Mo0o
From what I've read, BCG shouldn't come up pos after about 5 years or so. I use to come up pos and my old family physician just assumed it was the BCG but after I switched fam docs, the new one said that wasn't the case.

The studies produce conflicting results. However, several report that positive PPDs are seen in 25% of people 25 years after BCG.

The difficulty is that positive PPD is seen in active TB, so were the positive PPDs from the BCG or from TB?

 

[SirStev0]

A Positive PPD test isn't enough to diagnosis TB. There is a good chance of false positives. If you ever had the TB vaccine you would be positive.

A positive PPD would call for a Lung Xray. After that they can do some biopsies and such to conclusively prove you have.

In other words just because you have a positive PPD doesn't mean you have TB. Go to a doctor and don't ask for Medical Advice on ATOT.

 

[Mo0o]

Originally posted by: Mark R

Originally posted by: Mo0o
From what I've read, BCG shouldn't come up pos after about 5 years or so. I use to come up pos and my old family physician just assumed it was the BCG but after I switched fam docs, the new one said that wasn't the case.

The studies produce conflicting results. However, several report that positive PPDs are seen in 25% of people 25 years after BCG.

The difficulty is that positive PPD is seen in active TB, so were the positive PPDs from the BCG or from TB?

It's hard to be sure right. Since people that get BCGs are those who have lived in endemic areas so they could very well have latent TB from previous exposure since the vaccine isn't 100% effective. If they're not showing acute symptoms, hard to tell whats a bcg reaction and whats a legit TB rxn. Either way this is all nitpicking something that has nothing to do with the OP's question