Incidence of Drug-induced Liver Injury Among Government Tertiary Hospital Patients on Anti-Koch’s Treatment

Abstract

IntroductionTuberculosis (TB) remains a major global health problem. Anti-TB drugs have proven efficacy against TB; however, they can induce various adverse events, of which hepatoxicity is the most serious. Anti-tuberculosis drug-induced liver injury (ATLI) is emerging as a significant threat to TB control, though limited data is available at present. This study aims to estimate the incidence of ATLI and understand its clinical features.MethodologyThis was a single center, prospective study which consisted of a cohort of TB patients who received DOTS treatment at EAMC from December 2013 to May 2014. Only 285 patients, who were at least 18 years of age, were included. Clinical and laboratory features of ATLI were monitored for the treatment duration.ResultsWe monitored 240 TB patients; 52 were dropped from the study while 188 continued. Nine patients developed ATLI with cumulative incidence of 4.8% (95% CI, 2.4 – 7.19%). Nausea and abdominal pain were the most frequently observed signs and symptoms. Three (33.33%) ATLI patients had severe hepatotoxicity, 7 (77.77%) recovered, 1 (11.11%) failed to respond to treatment with continued elevation of aminotransferases and 1 (11.11%) died as a result of ATLI.Conclusion IntroductionTuberculosis (TB) remains a major global health problem. Anti-TB drugs have proven efficacy against TB; however, they can induce various adverse events, of which hepatoxicity is the most serious. Anti-tuberculosis drug-induced liver injury (ATLI) is emerging as a significant threat to TB control, though limited data is available at present. This study aims to estimate the incidence of ATLI and understand its clinical features. Tuberculosis (TB) remains a major global health problem. Anti-TB drugs have proven efficacy against TB; however, they can induce various adverse events, of which hepatoxicity is the most serious. Anti-tuberculosis drug-induced liver injury (ATLI) is emerging as a significant threat to TB control, though limited data is available at present. This study aims to estimate the incidence of ATLI and understand its clinical features. MethodologyThis was a single center, prospective study which consisted of a cohort of TB patients who received DOTS treatment at EAMC from December 2013 to May 2014. Only 285 patients, who were at least 18 years of age, were included. Clinical and laboratory features of ATLI were monitored for the treatment duration. This was a single center, prospective study which consisted of a cohort of TB patients who received DOTS treatment at EAMC from December 2013 to May 2014. Only 285 patients, who were at least 18 years of age, were included. Clinical and laboratory features of ATLI were monitored for the treatment duration. ResultsWe monitored 240 TB patients; 52 were dropped from the study while 188 continued. Nine patients developed ATLI with cumulative incidence of 4.8% (95% CI, 2.4 – 7.19%). Nausea and abdominal pain were the most frequently observed signs and symptoms. Three (33.33%) ATLI patients had severe hepatotoxicity, 7 (77.77%) recovered, 1 (11.11%) failed to respond to treatment with continued elevation of aminotransferases and 1 (11.11%) died as a result of ATLI. We monitored 240 TB patients; 52 were dropped from the study while 188 continued. Nine patients developed ATLI with cumulative incidence of 4.8% (95% CI, 2.4 – 7.19%). Nausea and abdominal pain were the most frequently observed signs and symptoms. Three (33.33%) ATLI patients had severe hepatotoxicity, 7 (77.77%) recovered, 1 (11.11%) failed to respond to treatment with continued elevation of aminotransferases and 1 (11.11%) died as a result of ATLI. Conclusion