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


Vijayalakshmi A, 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.


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References


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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Obrien RJ. Hepatotoxic reaction due to antituberculosis drugs: Adjustment to therapeutic regimen. JAMA 1991;265:3323.

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.

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.

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.




About this article

Title

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

DOI

10.22159/ajpcr.2016.v9i5.12756

Date

01-09-2016

Additional Links

Manuscript Submission

Journal

Asian Journal of Pharmaceutical and Clinical Research
Vol 9 Issue 5 September 2016 Page: 136-139

Print ISSN

0974-2441

Online ISSN

2455-3891

Statistics

118 Views | 146 Downloads

Authors & Affiliations

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

Thanmayi G

Jayakumari S


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