A PROSPECTIVE STUDY ON ABNORMAL LFT PATTERNS IN PATIENTS RECEIVING ANTITUBERCULOSIS THERAPY

  • Vijayalakshmi A Department of Pharmacognosy, SRM College of Pharmacy, SRM University, Kattankulathur, Chengalpet-603 203, Tamilnadu, India.
  • Thanmayi G
  • Jayakumari S

Abstract

Objective: Identification of risk factors associated with anti-tuberculosis drug-induced hepatotoxicity (anti-TB-DIH) is important, especially in an
endemic area for TB and liver disease. This study assessed the incidence and risk factors of anti-TB-DIH. Hence, the present study was designed to
evaluate the abnormal liver function test (LFT) in antitubercular therapy.

Methods: A total of 100 consecutive TB patients were prospectively followed up both clinically and biochemically before and during their course of
anti-TB therapy with daily doses of isoniazid, rifampin, ethambutol, and pyrazinamide, or streptomycin.

Results: In the study, 18-30 years 17 (17%), 31-50 years 28 (28%), 51-70 years 37 (37%), and 71-80 years 18 (18%) aged patients were found where 63 (63%) are males and 37 (37%) are females. Comparison between before treatment and 2 months treatment showed a significant increase in the level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP), viz., 51.6±3.92, 42.7±3.21, and 129±3.2 (U/L), respectively, as compared to pre-treatment levels. Comparison between before treatment and 2 months treatment showed a significant increase in the level of AST, ALT, and ALP, viz., 51.6±3.92, 42.7±3.21, and 129±3.2 (U/L), respectively, as compared to pre-treatment levels. Comparison between before treatment and after treatment (6 months) revealed a significant increase in the level of AST, ALT, ALP and gamma glutamyl transpeptidase (GGT) viz., 59.9±3.12, 51.6±3.66, 131.6±3.2, and 61±3.2 (U/L) respectively. The total bilirubin and direct bilirubin were found between 2.1±0.9 and 0.6±0.3 mg/dL respectively, when compared with before treatment.

Conclusion: Anti-TB-DIH is not uncommon, needs early recognition and treatment and is more in patients with pre-existing liver disease and lower
body mass index.

Keywords:
Anti-tuberculosis, Liver function test, Hepatotoxicity.

Author Biography

Vijayalakshmi A, Department of Pharmacognosy, SRM College of Pharmacy, SRM University, Kattankulathur, Chengalpet-603 203, Tamilnadu, India.

Asst. professor

Department of Pharmacognosy

References

1. Makhlouf HA, Helmy A, Fawzy E, El-Attar M, Rashed HA. A prospective study of antituberculous drug-induced hepatotoxicity in an area endemic for liver diseases. Hepatol Int 2008;2(3):353-60.
2. Lingaraja M, Venugopal K, Shashibushan J, Naik S. A study of liver function tests abnormalities in tuberculosis patients under RNTCP-DOTS, VIMS bellary. People’s J Sci Res 2015;8(1):28-33.
3. Sun HY, Chen IL, Gau CS, Chang SC, Luh KT. A prospective study of hepatitis during antituberculous treatment in Taiwanese patients and a review of the literature. J Formos Med Assoc 2009;108(2):102-11.
4. Wu S, Xia Y, Lv X, Zhang Y, Tang S, Yang Z, et al. Effect of scheduled monitoring of liver function during anti-Tuberculosis treatment in a retrospective cohort in China. BMC Public Health 2012;12:454.
5. Chih LH, Angela WF, Huang YS. Correlation of antituberculosis drug-related liver injury and liver function monitoring: A 12-year experience of the Taiwan Drug Relief Foundation. J Food Drug Anal 2014;22(3):356-62.
6. Tahaoglu K, Ataç G, Sevim T, Tärün T, Yazicioglu O, Horzum G, et al. The management of anti-tuberculosis drug-induced hepatotoxicity. Int J Tuberc Lung Dis 2001;5(1):65-9.
7. Saukkonen JJ, Cohn DL, Jasmer RM, Schenker S, Jereb JA, Nolan CM, et al. An official ATS statement: Hepatotoxicity of antituberculosis therapy. Am J Respir Crit Care Med 2006;174(8):935-52.
8. M’Kada H, Munteanu M, Perazzo H, Ngo Y, Ramanujam N, Imbert-Bismut F, et al. What are the best reference values for a normal serum alanine transaminase activity (ALT)? Impact on the presumed prevalence of drug induced liver injury (DILI). Regul Toxicol Pharmacol 2011;60(3):290-5.
9. World Health Organization. HIV/AIDS Programme. Antiretroviral Therapy for HIV Infection in Adults and Adolescents: Recommendations for a Public Health Approach. Geneva, Switzerland: World Health Organization; 2006.
10. Tostmann A, Boeree MJ, Aarnoutse RE, de Lange WC, van der Ven AJ, Dekhuijzen R. Antituberculosis drug-induced hepatotoxicity: Concise up-to-date review. J Gastroenterol Hepatol 2008;23(2):192-202.
11. Singh J, Garg PK, Tandon RK. Hepatotoxicity due to antituberculosis therapy. Clinical profile and reintroduction of therapy. J Clin Gastroenterol 1996;22(3):211-4.
12. Døssing M, Wilcke JT, Askgaard DS, Nybo B. Liver injury during antituberculosis treatment: An 11-year study. Tuber Lung Dis 1996;77(4):335-40.
13. Obrien RJ. Hepatotoxic reaction due to antituberculosis drugs: Adjustment to therapeutic regimen. JAMA 1991;265:3323.
14. Gulati K, Ray A, Vijayan VK. Assessment of protective role of polyherbal preparation Livina against anti-tubercular drug induced liver dysfunction. Inian J Exp Biol 2010;48(3):318-22.
15. Vargas-Mendoza N, Madrigal-Santillán E, Morales-González A, Esquivel-Soto J, Esquivel-Chirino C, García-Luna Y González-Rubio M, et al. Hepatoprotective effect of silymarin. World J Hepatol 2014;6(3):144-9.
16. Al-Salmi Z. Anti-tuberculosis drug-induced hepatitis in renal transplant patient with pulmonary and extra pulmonary tuberculosis. Saudi Pharm J 2012;20(2):181-5.
Statistics
261 Views | 246 Downloads
How to Cite
A, V., T. G, and J. S. “A PROSPECTIVE STUDY ON ABNORMAL LFT PATTERNS IN PATIENTS RECEIVING ANTITUBERCULOSIS THERAPY”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 9, no. 5, Sept. 2016, pp. 136-9, doi:10.22159/ajpcr.2016.v9i5.12756.
Section
Original Article(s)