Anti-Tuberculosis Drug Induced Hepatotoxicity and Associated Factors among Tuberculosis Patients at Selected Hospitals, Ethiopia

Abstract

Background Tuberculosis caused by susceptible mycobacterium tuberculosis strains is effectively treated by the first-line anti-tuberculosis drugs. However, most antibacterial drugs are known to induce hepatotoxicity which may limit their adherence and hence lead to the development of mycobacterial drug resistance. Objective The aim of this study was to assess the incidence of anti-tuberculosis drug induced hepatotoxicity and associated factors among tuberculosis patients of Debre Markos, Mota, and Bichena Hospitals. Methods The prospective cross sectional-study was conducted in three hospitals of East Gojjam zone by taking blood samples of new tuberculosis patients every 2 weeks for 2 months to measure the elevation of liver proteins indicating liver toxicity from the onset of starting therapy. A semi-structured questionnaire was also used to collect the socio-demographic data and factors of anti-tubeculosis drug induced liver toxicity. To identify factors associated with drug induced hepatotoxicity, binary logistic regression followed by multivariate analysis was applied at a statistically significant level of P <0.05. Results The incidence of hepatotoxicity among tuberculosis patients is 7.9%. Diagnosis of extrapulmonary tuberculosis, having comorbid disease, and old age are significantly associated ( P <0.05) with first-line antituberculosis drugs induced hepatotoxicity. Conclusion The incidence of hepatotoxicity is relatively high among tuberculosis patients taking first-line anti-tuberculosis drugs. Therefore, the liver function of patients with old age, comorbid diseases, and extrapulmonary tuberculosis should be regularly monitored to reduce the severity of drug-induced hepatotoxicity.

Drug-induced liver injury after anti tuberculosis drugs administration, how to diagnose? a case report

“…The patient was discharged from our hospital after 6 days of hospitalization. 7,8 In this patient, the laboratory result is ALT: 188 U/L (H), total bilirubin: 3.65 mg/dl (H), gamma GT 151 U/L (H) albumin 2.2 g/dl (L) anti Hcv negative; HbsAgNegatif ALP:115 U/L (N). There is now wide consensus that minor increases in ALT or AST that could result from adaptive and reversible liver responses to the drug (i.e., statins), or preexisting liver disease (i.e., fatty liver) should not be classified as DILI.…”

“…There is now wide consensus that minor increases in ALT or AST that could result from adaptive and reversible liver responses to the drug (i.e., statins), or preexisting liver disease (i.e., fatty liver) should not be classified as DILI. 7,8 The patient doesn't have history about liver disease or taking drug for dyslipidemia.…”

“…Liver toxicity can lead to discontinuation of the drug, which can then lead to the development of multidrug resistant tuberculosis (MDR-TB). 2,7 The diagnosis of DILI can be difficult because of the lack of specific signs, symptoms and tests and is partly a diagnosis based on exclusion. 7,8 In this case report, we will discuss how to diagnosis of DILI TB using RUCAM score.…”

“…2,7 The diagnosis of DILI can be difficult because of the lack of specific signs, symptoms and tests and is partly a diagnosis based on exclusion. 7,8 In this case report, we will discuss how to diagnosis of DILI TB using RUCAM score.…”

Pharmacokinetics of isoniazid and rifapentine in young pediatric patients with latent tuberculosis infection

“…All adverse events were graded using the Division of AIDS Table for Grading the Severity of Adult and Pediatric Adverse Events (National Institute of Allergy and Infectious Diseases, 2017), including rash, hepatotoxicity, nausea, vomiting, acute allergic reaction, anorexia, dyspnoea, and diarrhoea. Hepatotoxicity was defined as alanine aminotransferase elevation of >5 upper limit of normal (ULN) in the absence of hepatitis symptoms, or >3 ULN in the presence of symptoms and simultaneous elevation of total bilirubin >2 ULN (Molla et al, 2021). Laboratory tests, including complete blood count, fasting blood glucose, and renal and liver functions, were monitored at week-4, 12, and 24.…”