A Case series on the effect of ATT on liver function in freshly diagnosed cases of Pulmonary and extra Pulmonary Tubeculosis receiving dots therapy.

Dr. P. Sravani; Dr. P Srinivas Reddy; Dr. Neeharika Balla

Volume : X, Issue : VI, June - 2020

A Case series on the effect of ATT on liver function in freshly diagnosed cases of Pulmonary and extra Pulmonary Tubeculosis receiving dots therapy.

Dr. P. Sravani, Dr. P Srinivas Reddy, Dr. Neeharika Balla

Abstract :

AIMS and OBJECTIVES: To study the incidence and risk factors involved in development of hepatic damage and overt hepatitis in freshly diagnosed cases of pulmonary and extra pulmonary tuberculosis patients receiving anti tubercular treatment under RNTCP fixed dose combination (DOTS therapy) METHODS: In this prospective study, 100 freshly diagnosed pulmonary (95) and extra pulmonary tuberculosis(5) patients (67 males and 33 females) attending the outpatient clinic and DOTS Centre were taken up for study and were given ATT in fixed dose combinations as per RNTCP guidelines RESULTS: The study group of 100 pulmonary and extra pulmonary tuberculosis patients consisted of 67 males and 33 females. Age varied from 15 – 80 years. Twenty eight patients (28%) developed ATT induced liver damage which included 23 (23%) patients who had asymptomatic elevation of liver enzymes and 5 (5%) patients (3 extra pulmonary and 2 pulmonary TB) developed overt drug induced hepatotoxicity. 50% of cases in the age group of 51–60 years and 50% of cases in the age group of > 60 years developed drug induced liver damage. CONCLUSION: The incidence of asymptomatic elevation of liver enzymes secondary to ATT is 23% and incidence of overt DIH is 5%. Advanced age, high alcohol intake, BMI < 18, radiologically severe disease and pre–treatment hypoalbuminemia and extra pulmonary TB were found to be predisposing factors for the development of ATT induced hepatotoxicity while gender had no impact. Peak incidence of hepatitis occured in the first month of therapy.