HEPATOTOXICITY DUE TO ANTITUBERCULOSIS THERAPY: A PROSPECTIVE STUDY FROM A TERTIARY CARE CENTRE
Dr. Achal Sharma and Dr. Akanksha Mathur*
Objective: Tuberculosis is a significant problem in developing countries like India. The objective of the study was to find out the prevalence of anti-tubercular treatment induced hepatotoxicity and to determine the predisposing risk factors, if any. Methods: It was a prospective observational study involving 150 newly diagnosed tuberculosis patients on antitubercular therapy at a tertiare care centre. Clinical and epidemiological data including the risk factors predisposing to liver toxicity were collected through history taking and review of medical records. Baseline liver function tests were conducted before starting the therapy, one week after the therapy and whenever symptoms of hepatotoxicity arise. ATT induced hepatotoxicity was defined in accordance with the international consensus criteria. Statistical analyses were performed using the SPSS version 20.0 in terms of mean ± SD, absolute numbers and percentage. The chi-square test was used to compare the differences in variables between the two groups. p<0.05 was considered as significant. Results: 32(21.48%) out 150 tuberculosis patients developed hepatotoxicity during the course of treatment out of which 53% were males. ATT induced hepatotoxicity was most commonly associated with TB lymphadenitis 13(40.6%) followed by pleural effusion 9(28.5%), TB meningitis and miliary TB 3(9.3%). Smoking was found to favour development of ATT induced hepatotoxicity (p value-0.030). Rest other risk factors were not found to be statistically significant. Conclusion: Smoking was found to be related with the incidence of ATT induced hepatotoxicity significantly although it demands further analysis.
Keywords: Drug induced liver injury, DILI, tuberculosis, ATT.
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