BACKGROUND: Hepatotoxicity is one of the most serious adverse effects of anti-tuberculosis drugs (ATD). Although many risk factors have been associated with ATD-induced hepatotoxicity, their influence on hepatitis severity has not been studied systematically. OBJECTIVES: To evaluate whether the presence of hepatotoxicity risk factors (advanced age, chronic liver disease, abuse of alcohol or other drugs or malnutrition) influences the severity of ATD-induced hepatotoxicity. DESIGN: A prospective cohort study of 471 active tuberculosis patients treated with isoniazid, rifampicin and pyrazinamide and followed in a tuberculosis clinic between January 1998 and July 2002. Incidence of hepatotoxicity and its severity according to the presence or absence of ATD-induced hepatitis risk factors was evaluated. RESULTS: The incidence of ATD-induced hepatotoxicity (serum transaminase > 3 x the upper limit of normal [ULN]) was 18.2% (42/231 patients) in the risk factor group and 5.8% (14/240 patients) in the non-risk factor group (OR 3.5; 95% CI 1.9-6.7; P < 0.001). Severe hepatotoxicity (transaminase > 10 x ULN) occurred in 6.9% (16/231) of the risk factor group and in 0.4% (1/240) (OR 17.7; 95% CI 2.3-135; P < 0.001) of the group without risk factors. CONCLUSIONS: ATD-induced hepatitis is significantly more frequent and more severe in patients with hepatotoxicity risk factors.
BACKGROUND:Hepatotoxicity is one of the most serious adverse effects of anti-tuberculosis drugs (ATD). Although many risk factors have been associated with ATD-induced hepatotoxicity, their influence on hepatitis severity has not been studied systematically. OBJECTIVES: To evaluate whether the presence of hepatotoxicity risk factors (advanced age, chronic liver disease, abuse of alcohol or other drugs or malnutrition) influences the severity of ATD-induced hepatotoxicity. DESIGN: A prospective cohort study of 471 active tuberculosispatients treated with isoniazid, rifampicin and pyrazinamide and followed in a tuberculosis clinic between January 1998 and July 2002. Incidence of hepatotoxicity and its severity according to the presence or absence of ATD-induced hepatitis risk factors was evaluated. RESULTS: The incidence of ATD-induced hepatotoxicity (serum transaminase > 3 x the upper limit of normal [ULN]) was 18.2% (42/231 patients) in the risk factor group and 5.8% (14/240 patients) in the non-risk factor group (OR 3.5; 95% CI 1.9-6.7; P < 0.001). Severe hepatotoxicity (transaminase > 10 x ULN) occurred in 6.9% (16/231) of the risk factor group and in 0.4% (1/240) (OR 17.7; 95% CI 2.3-135; P < 0.001) of the group without risk factors. CONCLUSIONS: ATD-induced hepatitis is significantly more frequent and more severe in patients with hepatotoxicity risk factors.
Authors: Sonya S Shin; Trini A Mathew; Galina V Yanova; Garrett M Fitzmaurice; Viktoriya Livchits; Sergey A Yanov; Aivar K Strelis; Sergey P Mishustin; Nicolai A Bokhan; Charmaine S Lastimoso; Hilary S Connery; Jessica E Hart; Shelly F Greenfield Journal: Cent Eur J Public Health Date: 2010-09 Impact factor: 1.163
Authors: Shelly F Greenfield; Alan Shields; Hilary Smith Connery; Viktoriya Livchits; Sergey A Yanov; Charmaine S Lastimoso; Aivar K Strelis; Sergey P Mishustin; Garrett Fitzmaurice; Trini A Mathew; Sonya Shin Journal: Alcohol Clin Exp Res Date: 2009-11-20 Impact factor: 3.455
Authors: Trini A Mathew; Alan L Shields; Aizhan Imasheva; Sonya S Shin; Sergey P Mishustin; Gennady G Peremitin; Aivar K Strelis; Galina V Yanova; Shelly F Greenfield; Jennifer J Furin Journal: Cult Med Psychiatry Date: 2009-12
Authors: Yin Yin Xia; Dai Yu Hu; Fei Ying Liu; Xiao Meng Wang; Yan Li Yuan; De Hua Tu; Yi Xin Chen; Lin Zhou; Li Zhen Zhu; Wei Wei Gao; Hong Yuan Wang; Da Fang Chen; Li Yang; Ping Ping He; Xiao Ting Li; Ying Jian He; Feng Sun; Si Yan Zhan Journal: BMC Public Health Date: 2010-05-21 Impact factor: 3.295