Can we prevent fatalities due to antituberculous drugs?

Abstract

Objective: To assess the incidence and risk factors for liver toxicity in patients on anti-tuberculosis treatment. Method: All patients with a diagnosis of tuberculosis, who were to receive ATT during the study period, were included in the present study for prospective periodic laboratory monitoring for the development of hepatotoxicity. Results: Of the 352 patients studied, 61 patients (17%) had elevated hepatic transaminases value after starting antituberculous therapy (ATT), 36 grade 1 (10%), 7 grade 2 (2%), 12 grade 3 (3.4%), and 6 patients grade 4 (1.7%). The incidence of severe hepatotoxicity (grades 3, 4) among treated patients was 5.1% (18 patients). The mean duration of treatment before onset of hepatotoxicity was 36 days. Although the majority of patients developed hepatic dysfunction within the first 2 months of treatment, significant hepatotoxicity (grades 3, 4) did occur at a later date in some patients (28%). Univariate analysis did not show any significant relationship between age, sex, and ethnic origin with hepatotoxicity in this study. The only significant risk factor was coexisting hepatitis B or C. None of our patients died from complications of liver-related illness attributed to anti-TB drugs.