Study of Anti–tuberculosis Treatment associated hepatotoxicity and related Risk Factors

Dr.Vishvanayak; Dr. B. Kumar

Volume : VI, Issue : V, May - 2016

Study of Anti–tuberculosis Treatment associated hepatotoxicity and related Risk Factors

Dr. Vishvanayak, Dr. B. Kumar

Abstract :

Our study evaluates the clinical risk factors associated with the development of hepatotoxicity in patients with tuberculosis on antitubercular treatment. Three groups of patients were studied over 1 year period in 2014–2015. Patients given ATT were followed up with monthly LFTs. Consecutive patients who developed liver dysfunction (rise in SGPT > 3 times upper limit of normal) were studied, along with matched controls who did not. Markers for hepatitis B were also noted in these patients once in 6 months. A third group of patients who did not receive ATT but were HBsAg positive, were also similarly followed up. The possible association of age and sex of the patient, alcoholism, unrecognized chronic liver disease, hepatitis B virus carrier state and nutritional status with ATT–induced hepatitis was assessed. In addition 128 patients on anti–tuberculosis drugs without hepatotoxicity and 39 HBsAg carriers not on ATT were followed up for 1 year. We found that Age, Sex, history of alcohol intake and BMI were not found to be related to development of hepatotoxicity. Presence of HBV infection or an underlying silent chronic liver disease was found to significantly increase the risk of development of ATT–induced hepatotoxicity. Continuation of ATT after development of jaundice was associated with a high fatality rate. It was possible to re–introduce isoniazid in 96% and rifampicin in 88% of patients with ATT induced hepatotoxicity. Discontinuation of ATT leads to rapid recovery in most cases and drugs can safely be introduced after recovery in a majority of cases.