Nisa Maria, Maksum Radji, Erlina Burhan



 Objective: This study aimed to evaluate the impact of antituberculosis (anti-TB) drug-induced hepatotoxicity (DIH) to outcome TB treatment.

Methods: A cohort retrospective study conducted at a tertiary hospital in Jakarta - Indonesia, from the period of 2013-2016. A total of 76 samples of TB patient with and without anti-TB DIH were analyzed.

Results: Successful outcome TB treatment for TB patient with anti-TB DIH is 47.4% compared to TB patient without anti-TB DIH is 78.9%. Relative risk (RR) analysis showed that risk of unsuccessful TB treatment for TB patient with anti-TB DIH is 2.50 fold higher (95% confidence interval: 1.259- 4.960) than TB patient without anti-TB DIH. Age, sex, and comorbidities are not statistically significant to outcome TB treatment. For TB patient with anti-TB DIH, onset anti-TB DIH and recurrence anti-TB DIH also not statistically significantly influence outcome TB. The mean duration of treatment for a successful outcome for TB patient with and without anti-TB DIH was statistically significant (p<0.05), respectively, 8.44±1.85 and 6.52±0.93 months.

Conclusion: Anti-TB DIH increases the risk of unsuccessful and prolonged duration TB treatment.


Antituberculosis, Drug-induced hepatotoxicity, Outcome.

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Zumla A, Raviglione M, Hafner R, von Reyn CF. Tuberculosis. N Eng J Med 2013;368(8):745-55.

World Health Organization. Global Tuberculosis Report 2015. Geneva: World Health Organization; 2016.

Singla R, Sharma SK, Mohan A, Makharia G, Sreenivas V, Jha B, et al. Evaluation of risk factors for anti-tuberculosis treatment induced hepatotoxicity. Indian J Med Res 2010;132:81-6.

Tostmann A, Boeree MJ, Aarnoutse RE, de Lange WC, van der Ven AJ, Dekhuijzen R. Anti-tuberculosis drug-induced hepatotoxicity: Concise up-to-date review. J Gastroenterol Hepatol 2008;23(2):192-202.

Verma R, Mahor GR, Shirvastava AK, Pathak P. Adverse drug reactions with first-line anti-tubercular drugs in a tertiary care hospital of central India: A study of clinical presentations, causality, and severity. Asian J Pharm Clin Res 2014;7(5):140-3.

Siddiqui S, Baig MM, Jafer S, Ansari SF. Study on prevalence of adverse drug reactions in patients suffering from tuberculosis in a tertiary care hospital. Int J Pharm Pharm Sci 2016;8(8):375-7.

Satyaraddi A, Velpandian T, Sharma SK, Vishnubhatla S, Sharma A, Sirohiwal A, et al. Correlation of plasma anti-tuberculosis drug levels with subsequent development of hepatotoxicity. Int J Tuberc Lung Dis 2014;18(2):188-95, i-iii.

Penghui S, Xia Y, Liu F, Wang X, Yuan Y, Hu D, et al. Incidence, clinical features and impact on anti-tuberculosis treatment of anti-tuberculosis induced liver injury (ATLI) in China. PLoS One 2011;6:7.

Ministry of Health of Indonesia. National Guideline for Medical Treatment of Tuberculosis. Jakarta: Ministry of Health of Indonesia; 2013.

An H, Wu X, Wang Z, Xu J, Zheng S, Wang K. The clinical characteristics of anti-tuberculosis drug induced liver injury in 2457 hospitalized patients with tuberculosis in China. Afr J Pharm Pharmacol 2013;7(13):710-4.

World Health Organization. Treatment of Tuberculosis Guidelines. 4th ed. Geneva: World Health Organization; 2010.

Sharma SK. Tuberculosis. 2nd ed. New Delhi: Jaypee Brothers Medical Publisher (P) Ltd.; 2009.

Sharifzadeh M, Rasoulinejad M, Valipour F, Nouraie M, Vaziri S. Evaluation of patient-related factors associated with causality, preventability, predictability and severity of hepatotoxicity during anti-tuberculosis [correction of anti-tuberclosis] treatment. Pharmacol Res 2005;51(4):353-8.

Abera W, Cheneke W, Abebe G. Incidence of anti-tuberculosis-drug-induced hepatotoxicity and associated risk factors among tuberculosis patients in Dawro Zone, South Ethiopia: A cohort study. Int J Mycobacteriol 2016;5(1):14-20.

Buntoro IK, Kristin E, Sumardi S. Decrease of liver function after treatment of anti-tuberculosis drugs in tuberculosis patients with malnutrition and alcohol consumption. Int J Pharm Pharm Sci 2016;8(7):269-73.

Chemotherapy and management of tuberculosis in the United Kingdom: Recommendations 1998. Joint Tuberculosis Committee of the British Thoracic Society. Thorax 1998;53:536-48.

Saukkonen JJ, Cohn DL, Jasmer RM, Schenker S, Jereb JA, Nolan CM, et al. An official ATS statement: Hepatotoxicity of anti-tuberculosis therapy. Am J Respir Crit Care Med 2006;174(8):935-52.

Sharma SK, Singla R, Sarda P, Mohan A, Makharia G, Jayaswal A, et al. Safety of 3 different reintroduction regimens of anti-tuberculosis drugs after development of anti-tuberculosis treatment-induced hepatotoxicity. Clin Infect Dis 2010;50(6):833-9.

Devarbhavi H. Anti-tuberculous drug-induced liver injury: Current perspective. Trop Gastroenterol 2011;32(3):167-74.

Agal S, Baijal R, Pramanik S, Patel N, Gupte P, Kamani P, et al. Monitoring and management of anti-tuberculosis drug induced hepatotoxicity. J Gastroenterol Hepatol 2005;20:1745-52.

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(11):454.

Muñoz-Sellart M, Cuevas LE, Tumato M, Merid Y, Yassin MA. Factors associated with poor tuberculosis treatment outcome in the Southern region of Ethiopia. Int J Tuberc Lung Dis 2010;14(8):973-9.

Baker MA, Harries AD, Jeon CY, Hart JE, Kapur A, Lönnroth K, et al. The impact of diabetes on tuberculosis treatment outcomes: A systematic review. BMC Med 2011;9:81.

Singanayagam A, Sridhar S, Dhariwal J, Abdel-Aziz D, Munro K, Connell DW, et al. A comparison between two strategies for monitoring hepatic function during anti-tuberculous therapy. Am J Respir Crit Care Med 2012;185(6):653-9.

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Pharmacy (Clinical Pharmacy)


Antituberculosis, Drug-induced hepatotoxicity, Outcome.





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Asian Journal of Pharmaceutical and Clinical Research
Vol 10 Issue 11 November 2017 Page: 194-198

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Authors & Affiliations

Nisa Maria
Department of Pharmacy, Faculty of Pharmacy, University of Indonesia, Depok, Indonesia.

Maksum Radji
Department of Pharmacy, Faculty of Pharmacy, University of Indonesia, Depok, Indonesia.

Erlina Burhan
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia. Department of Pulmonology and Respiratory, Persahabatan Hospital, Jakarta, Indonesia.

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