Prevalence and Risk Factors Associated with First-Line
Anti-Tuberculosis Induced Hepatotoxicity in Suratthani
Hospital, Thailand
Thotsaporn Morasert MD¹, Thanawat Ruengchaisiwawaith MD²
Affiliation :
¹ Pulmonary and Critical Care Medicine, Department of Internal Medicine, Suratthani Hospital, Surat Thani, Thailand ² Division of General Internal Medicine, Department of Internal Medicine, Suratthani Hospital, Surat Thani, Thailand
Background : Tuberculosis (TB) is a major public health problem, including Thailand. Anti-TB drugs are very effective treatment, but they can cause
hepatotoxicity. Data on the prevalence of anti-TB drug-induced hepatotoxicity (DIH), as well as the contributing risk factors, are scarce in Thailand.
Objective : To measure the prevalence and identify risk factors associated with first-line drugs (FLD) induced hepatoxicity in TB patients.
Materials and Methods : The present study was a retrospective study design in TB clinic of Suratthani Hospital, in Southern Thailand. All patients diagnosed with TB and received FLD between January and December 2017, were eligible for the study. Hepatoxicity defined as the following criteria: serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels >5x upper limit of normal (ULN) without symptoms, or AST or ALT >3x ULN with clinical symptoms.
Results : Of all the 198 TB cases, 18 were identified as DIH. Prevalence of DIH was 9.1%. Hepatitis after FLD was independently associated with age >60 years (adjusted OR [aOR] 28.49, 95% CI 2.68 to 302.95, p=0.005) and serum albumin <3.5 g/dL (aOR 20.97, 95% CI 2.11 to 208.51, p=0.009).
Conclusion : Age of more than 60 years and low serum albumin of less than 3.5 g/dL were significant risk factors associated with first-line anti-TB drugs induced hepatoxicity.
Received 22 June 2020 | Revised 15 October 2020 | Accepted 15 October 2020
doi.org/10.35755/jmedassocthai.2021.02.11550
Keywords :
Hepatoxicity, Anti-tuberculosis drug, Risk factor, Thailand
All Articles
Download