|
|
||||
|
Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
||||
|
ISSN 1681-715X |
||||
|
||||
|
- |
||||
|
ORIGINAL ARTICLE- |
||||
|
- |
||||
|
Volume 23 |
January - March 2007 |
Number 1 |
||
|
|
||||
|
|
||||
|
|
||||
|
Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
||||
|
ISSN 1681-715X |
||||
|
||||
|
- |
||||
|
ORIGINAL ARTICLE- |
||||
|
- |
||||
|
Volume 23 |
January - March 2007 |
Number 1 |
||
|
|
||||
|
|
||||
Hepatotoxicity with Antituberculosis Drugs: The risk factors
Khalid Mahmood1, Akhtar Hussain2, Krishan Lal Jairamani3,
Abu Talib4, Badar-uddin Abbasi5, S. Salkeen6ABSTRACT
Objective: To assess the severity and frequency of hepatotoxicity caused by different antituberculosis (ATT) drugs and to evaluate whether concurrence of risk factors influence the antituberculosis drug induced hepatotoxicity.
Method: This prospective cohort study was conducted in Medical Unit-V and OPD department of Civil Hospital Karachi from July 2004 to July 2005. A total of 339 patients diagnosed of active tuberculosis infection with normal pretreatment liver function were monitored clinically as well as biochemically. Their data were collected on proforma and patients were treated with Isonized, Rifampicin and Pyrazinamide. Duration after which derangement in function, if any, occurred and time taken for normalization was noted. Treatment was altered as needed, with exclusion of culprit drug. Finally data was analyzed by SPSS version 10.0.
Results: ATT induced hepatotoxicity was seen in 67 (19.76%) out of 339 patients. Females were more affected as compared to males (26.3% vs. 19.7%). BMI (kg/m2) of 91% of diseased group were less than 18.5 (p<0.01) most of them were anemic having low albumin level suggestive of lean body mass. Hepatotoxicity was more severe in AFB smear positive patients. Concomitant use of alcohol, paracetamol and low serum cholesterol were proved as predisposing factors. Isoniazid [37 patients (55.21%), p<0.01] was the main culprit followed by Rifampicin (23 patients, 34.21%) and Pyrazinamide (7 patients, 10.5%). Most of the patients (61%) developed the hepatotoxicity within two weeks of starting antituberculosis therapy with mild to moderate alteration in ALT and AST.
Conclusion: ATT-induced hepatitis is significantly more frequent and more severe in patients with hepatotoxicity risk factors.
KEY WORDS: Hepatotoxicity, Anti-TB drugs, Tuberculosis, Risk factors.
Pak J Med Sci January - March 2007 Vol. 23 No.1 33-38
1. Dr. Khalid Mahmood, FCPS
Professor of Medicine
2. Dr. Akhtar Hussain Samo, FCPS
Resident Medical Officer
3. Dr. Krishan Lal Jairamani DTM&ID, FCPS
Resident Medical Officer
4. Dr. Abu Talib, FCPS
Associate Professor of Medicine
5. Dr. Badar-uddin Abbasi, FCPS
6. Dr. S. Salkeen, FCPS5&6: Assistant Professor of Medicine,
1-6: Department of Medicine, Medical Unit –V
Dow Medical College & Civil Hospital,
Karachi- Pakistan.Correspondence:
Dr. Khalid Mahmood
3-Sunny Side 69-A, Street-1
Bath Island, Karachi-Pakistan.
E mail: profkhalid@yahoo.com* Received for Publication: March 2, 2006
* Accepted: September 30, 2006
HOME | SEARCH | CURRENT ISSUE | PAST ISSUES
Professional
Medical Publications
Room No. 522, 5th Floor, Panorama Centre
Building No. 2, P.O. Box 8766, Saddar, Karachi - Pakistan.
Phones : 5688791, 5689285 Fax : 5689860
pjms@pjms.com.pk
