Abstract
BACKGROUND: We describe drug-induced liver injury (DILI) secondary to antituberculous treatment (ATT) in a large tuberculosis (TB) centre in London; we identify the proportion who had risk factors for DILI and the timing and outcome of DILI.
METHODS: We identified consecutive patients who developed DILI whilst on treatment for active TB; patients with active TB without DILI were selected as controls. Comprehensive demographic and clinical data, management and outcome were recorded.
RESULTS: There were 105 (6.9%) cases of ATT-associated DILI amongst 1529 patients diagnosed with active TB between April 2010 and May 2014. Risk factors for DILI were: low patient weight, HIV-1 co-infection, higher baseline ALP, and alcohol intake. Only 25.7% of patients had British or American Thoracic Society defined criteria for liver test (LT) monitoring. Half (53%) of the cases occurred within 2 weeks of starting ATT and 87.6% occurred within 8 weeks. Five (4.8%) of seven deaths were attributable to DILI.
CONCLUSIONS: Only a quarter of patients who developed DILI had British or American Thoracic Society defined criteria for pre-emptive LT monitoring, suggesting that all patients on ATT should be considered for universal liver monitoring particularly during the first 8 weeks of treatment.
| Original language | English |
|---|---|
| Pages (from-to) | 231 |
| Journal | BMC Infectious Diseases |
| Volume | 17 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 24 Mar 2017 |
Keywords
- tuberculosis
- drug induced liver injury
- hepatotoxicity
- re-introduced regimen
- RISK FACTORS
- LIVER FAILURE
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This is the final published version of the article (version of record). It first appeared online via BioMed central at https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2330-z. Please refer to any applicable terms of use of the publisher.