Abstract:
Background: Antituberculosis drugs cause hepatotoxicity in some individuals leading to
acute liver failure, which results in death. Such phenomena limit the clinical use of drugs,
contributing to treatment failure that possibly causes drug resistance. Furthermore, associated risk factors for the development of antituberculosis-drug-induced hepatotoxicity
(anti-TB-DIH) are found to be controversial among different study findings.
Methods: A prospective cohort study was conducted from May 2014 to October 2014 in
Dawro Zone, Tercha District Hospital Laboratory, South Ethiopia. One hundred and
twenty-four new tuberculosis-positive individuals available from Tercha Hospital and five
health centers during data collection were consecutively included. The sociodemographic
data and anthropometric measurement were obtained. Then, 5 mL of venous blood was
drawn from each individual, and the alanine transaminase, aspartate transaminase, and
total bilirubin were measured photometrically at baseline, and then continuously monitored by measuring these liver enzymes every 2 weeks for 2 months. Data were analyzed
with SPSS version 20 for Windows (SPSS Inc., Chicago, IL, USA).
Results: The incidence of anti-TB-DIH was found to be 8% (10 patients out of 124). Raised
serum transaminase and bilirubin level, as well as signs and symptoms of hepatotoxicity
(nausea, anorexia, vomiting, malaise, and jaundice), were observed in the cases. The onset
of hepatotoxicity ranged from 13 days to 58 days (median, 26 days) after treatment was
initiated. Of the various risk factors analyzed, only high alcohol intake was associated with
the incidence of anti-TB-DIH (odds ratio = 9.3, 95% confidence interval 1.8–47, p < .007). Age,
gender, extent of tuberculosis disease, and malnutrition were not significantly associated
with anti-TB-DIH.
Conclusion: The incidence of anti-TB-DIH in Dawro Zone was high. The drug responsible for
the hepatotoxicity was not known. However, chronic high alcohol intake was associated
with the development of anti-TB-DIH.
2015 Asian-African Society for Mycobacteriology. Production and hosting by Elsev
