Gender Differences and Treatment Outcome among Drug Induced Hepatotoxicity Tuberculosis Patients

Kamini Nadarajah,Amer Hayat Khan,Raja Ahsan Aftab,Imam Shaik,Irfhan Ali

doi:10.2174/1874220301906010026

Kamini Nadarajah, Amer Hayat Khan + Show 3 more

Open Access

https://doi.org/10.2174/1874220301906010026

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Journal: Open medicine journal	Publication Date: Apr 30, 2019
License type: CC BY 4.0

Affiliation: Taylor's University

Abstract

Aims and Objective: The aim of the current manuscript is to determine the association between gender differences and drug-induced hepatotoxicity among patients receiving anti-tuberculosis therapy and to determine the outcome of the treatment. Methods: A retrospective observational study was conducted among tuberculosis patients at Respiratory Clinic of Penang General Hospital (PGH) and Bukit Mertajam Hospital. A validated data collection instrument was used to collect patients’ demographic and clinical data confirmation of drug induced hepatotoxicity among tuberculosis patients was based on biochemical criteria which included 3 fold increase in liver enzymes in response to anti TB medication. All results were analyzed through SPSS version 20. Results: The study subjects were predominantly males 146 (76.8%) than females 44 (23.2%). Drug-induced hepatotoxicity with anti-tuberculosis drugs was observed the most among Chinese 90 (47%) ethnicity. Eighty-five (72%) male and 33 female (28%) tuberculosis drug-induced (TB-DIH) patients had a successful treatment outcome. Female patients had a statistically significant positive association with successful TB-DIH treatment outcomes (OR=1.83, 0.988-3.390 95%CI). Upon multivariate analysis, Indian ethnicity (OR = 0.173, p = 0.024), patients with relapse of Tuberculosis (TB) (OR= 0.332, p = 0.032) and Human Immune Virus (HIV) (OR= 0.217, p = 0.027) were less likely to have successful TB-DIH treatment outcomes. Conclusion: Female Tuberculosis Drug Induced Hepatotoxicity (TB DIH) patients were more likely to have successful treatment outcomes. A number of factors such as Indian ethnicity, patients with relapse of Tuberculosis (TB) and patients with Human Immune Virus (HIV) were less likely to have successful TB DIH treatment outcomes.

Highlights

Tuberculosis (TB) is one of the pre-historical diseases known to mankind and still remains the leading single infectious cause of death among adults [1]
We observed that male patients had a higher percentage of concurrent risk factors such as smoking, diabetes mellitus, and alcohol consumption which predispose to the incidence of tuberculosis
The incidence of anti-TB DIH observed in the current study is similar to those reported from Western countries and in Malaysia

Summary

Introduction

Tuberculosis (TB) is one of the pre-historical diseases known to mankind and still remains the leading single infectious cause of death among adults [1]. It is believed that one in three is either infected with Mycobacterium tuberculosis, or is at risk of developing the disease [2]. The. WHO classified Malaysia as an ‘intermediate’ TB burden country in 2004. In the last 20 years, the incidence rate has been stagnating, there was a slight upward trend between 2004 and 2006, from 60.3 to 62.6 per 100,000 [3]. The global increasing threat of drug resistance and multidrug resistant TB (MDR-TB) is another important reason for the TB epidemic. In 2008, MDR-TB emerged with an estimated 440,000 cases globally [2]. Almost 50% of MDR-TB cases worldwide are estimated to occur in China and India [2].

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Conclusion