ANTI-TUBERCULOSIS THERAPY

Derangement in liver enzymes among patients undergoing Anti-tuberculosis therapy

Abstract

… Objectives: Tuberculosis (TB) is a major cause of illness and death worldwide,
especially in Asia and Africa. An effective control has been achieved by the widespread use of
ATT. It has been postulated that hepatotoxicity induced by ATT is not truly idiosyncratic in
essence; rather certain genetic and environmental factors are attributed to coincide to produce
sufficient quantity of toxic metabolites that then cause varied alterations in liver functions.
Objective of the study was to determine the frequency of derangement of liver enzymes in
patients taking anti-tuberculous therapy within the first 8 weeks of therapy. Study Design: A
descriptive case series study. Place and Duration of Study: The study was conducted at the inpatient
and out-patient department of general medicine of Pakistan Institute of Medical Sciences
(PIMS), Islamabad for blood sampling and biochemical assays. Material and Methods: The
study was performed on a total of 114 patients of tuberculosis. ATT was started after baseline liver
function tests. Liver function tests were repeated at 4 weeks and 8 weeks to observe the effects on
liver enzymes derangement. Results: 12 patients had deranged LFTs while 102 patients had
normal LFTs after 4 weeks of treatment while 10 patients had deranged LFTs and 104 patients had
normal LFTs after 8 weeks of treatment. Conclusions: Anti-tuberculosis drugs induced
hepatotoxicity occurs less frequently. All patients put on anti-tuberculous therapy must be
followed up for at least the initial 4 weeks, and the patient and caregivers should be told how to
recognize signs of anti-tuberculous induced hepato-toxicity.