Abstract
Background: Tuberculosis and liver disease are both endemic in many parts of the world. Many anti-TB drugs have hepatotoxic side effects and should be used cautiously during its use in liver disease patients.
Objectives: To assess the frequency and risk factors of anti-TB-Drug-Induced-Hepatotoxicity (Anti-TB DIH) among patients with viral hepatitis and liver cirrhosis.
Patients & Methods: This prospective study included 26 TB patients of pulmonary and extrapulmonary TB associated with liver cirrhosis or viral hepatitis in addition to, 46 TB patients without liver disease as controls. All patients were followed up clinically and biochemically before and during their treatment.
Results: Anti-TB-DIH was noticed in 30.8% patients with liver disease (46.2% and 15.4% in liver cirrhosis and viral hepatitis respectively; P=0.089) and in 8.7% of control group (P< 0.05 versus liver disease). Anti-TB-DIH developed within 15-60 days from the onset of therapy. Liver functions normalized in 25% of patients with liver disease within 2 weeks from cessation of therapy. By univariate analysis, liver diseased patients with anti-TB-DIH had lower body mass index (P=0.049) and lower serum albumin (P=0.008). Using multivariate regression analysis proved that lower serum albumin was independent predictors of anti-TB-DIH (P=0.018) in liver diseased patients while the presence of other co morbid diseases was the only risk factor in patients without liver disease (P=0.024).
Conclusion: Anti-TB-DIH is common among patients with liver diseases and is more in patients with lower serum albumin while the presence of other co morbid diseases is only risk factor for DIH in TB patients without liver disease.
- © 2011 ERS