From Medical & Surgical Nursing - Assessment & Management of Clinical Problems:
"The major side affect of isoniazide, rifanpin, and pyrizinamide is hepatitis."
They will want to monitor your liver functions, especially if you're over 35 years old.
It can cause elevated liver enzymes up to 3 times normal without symptoms "does not constitute an indication to stop therapy." Isoniazide is primarily metabolized by the liver and excreted by the kidneys. Pyridoxine (vitamin B6) administration during high-dose therapy as prophylactic measure, use as single prophylactic agent for active TB in individuals whose PPD converts to positive, ability to cross blood-brain barrier.
What it does is interferes with the DNA metabolism of tubercole bacillus.
Some of the side effects of isoniazide are: peripheral neuritis, hepatotoxicity, hypersensitivity (skin rash, arthralgia, fever), optic neuritis, vitamin B6 neuritis.
To paraphrase JarJar Binks, "meesa thinks youza gonna" be just fine. Just follow your doctors advice. Oh, and as mentioned above, my wife has never heard of anyone being put on treatment only for a positive conversion (your test.)
A positive reaction indicates the presence of a tuberculous infenction, but it does not show whether the infection is dormant or active, causing a clinical illness. Because the response to TB skin testing may be decreased in the immunocomporomised patient, induratino reactions less than 10mm may be considered positive.
Chest X-ray: Although the findings on chest x-ray examination are important, it is not possible to make a diagnosis of TB solely on the basis of this examination...
Bacteriologic Studies: The demonstration of tubercle baccili bacteriologically is essential (my emphasis) for establishing a diagnosis. Microscopic examination of stained sputum smears for acidfast baccili is usually the first bacteriologic evidence of the presence of tubercle bacilli...
The most accurate means of diagnosis is a culture technique (may take 6 to 8 weeks). Advantage: it can detect small quantities (as few as 10 bacteria per milliliter of specimen)
Serologic diagnosis of TB using enzyme-linked immunosorbent assay (ELISA) methodology to measure IgG antibody against mycobacterial antigens is a new and promising technique. DNA fingerprinting uses the polymerase chain reaction technique to identify individual strains of M. tuberculosis.
Drug therapy: In view of the growing prevalence of multidrug-resistant TB, the patient with active (my emphasis again) TB should be managed aggressively. Standard therapy has been revised because of the increase in prevalence of drug-resistant TB. Treatment of TB usually consists of a combination of at least four drugs... It has been shown that single-drug therapy can result in rapid development of resistant strains.
The five primary drugs used are isoniazid, rifampin, pyrazinamide, streptomycin, and ethambutol.
From the above, most of the time, therapy is only given for active infections. HOWEVER:
Indications for Preventive TB Therapy:
*Newly infected patient
*Person with known or suspected HIV infection and positive skin test
*Exposure of household members and other close associates to newly diagnosed patient
*Significant tuberculin skin test reactors with abnormal chest x-ray
*Significant tuberculin skin test reactors in special clinical situations (person takes corticosteroids; has diabetes mellitus, silicosis, gastrectomy, or end-stage renal disease)
*Other significant tuberculin skin test converters (>-10 mm increase within a 2 year period for those less than 35 years old; >- 15 mm increase for those greater than 35 years old; all children less than 2 years old with a >10 mm skin test.
*Other significant tuberculin skin test reactors in person less than 35 years old (persons born outside of US from high-prevalence countries; medically underserved low-income populations including high risk racial or ethnic populations, such as African-Americans, Hispanic, and Native-Americans; residents in long-term care facilities.)
edit: oh, and what they said: they'll monitor your liver enzymes to make sure you're just fine. Hell, I had a toenail injury which led to a toenail fungus getting established, which led to it spreading to most of my other toenails. I had to take some drug to get rid of it. Worked great, but they had to monitor my enzymes due to the possibility of it harming my liver. No hesitation on my part. I have a lot more information in several books, but none really spends any time going over the liver aspect. I think it's more of a concern to you than it apparently should be. Just like any standard treatment, there is that very small percentage of cases that the standard treatment is causing unacceptable other effect to. And, for these people, the therapy is changed. Some of the other therapies for active TB are considered more toxic, hence they're not the first line choice for treatment.
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