Frequency and risk factors of drug-induced liver injury during treatment of multidrug-resistant tuberculosis

Int J Tuberc Lung Dis. 2016 Jun;20(6):800-5. doi: 10.5588/ijtld.15.0668.

Abstract

Objectives: To investigate the risk factors for drug-induced liver injury (DILI) during the treatment of multidrug-resistant tuberculosis (MDR-TB) and to compare the frequency of DILI in patients with and those without chronic liver disease (CLD).

Setting: This was a retrospective observational cohort study including 299 consecutive patients who started MDR-TB treatment from January 2009 to December 2013.

Design: Of the 299 patients, 35 had alcoholic liver disease (ALD group), 16 had hepatitis B virus infection (HBV group) and 11 had hepatitis C virus infection (HCV group). The remaining 237 patients without CLD were selected as the control group.

Results: DILI occurred in 29 (9.7%) patients. The frequency of DILI was significantly higher in the ALD (17.1%, P = 0.038), HBV (31.3%, P = 0.005) and HCV groups (27.3%, P = 0.037) than in the control group (6.3%). Among all patients taken together, having HBV and HCV infection were independent risk factors for the occurrence of DILI during MDR-TB treatment.

Conclusion: DILI during MDR-TB treatment occurred more frequently in patients with CLD due to ALD, HBV and HCV infection than in those without CLD.

MeSH terms

  • Adult
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / adverse effects*
  • Chemical and Drug Induced Liver Injury / diagnosis*
  • Female
  • Follow-Up Studies
  • Hepatitis B / epidemiology
  • Hepatitis C / epidemiology
  • Humans
  • Liver Diseases, Alcoholic / epidemiology
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / epidemiology

Substances

  • Antitubercular Agents