R J Bright-Thomas1, A R Gondker2, J Morris3, L P Ormerod4. 1. Department of Respiratory Medicine, University Hospital South Manchester, Manchester, Institute of Inflammation and Repair, University of Manchester, Manchester. 2. Chest Clinic, Royal Blackburn Hospital, Haslingden Road, Blackburn. 3. Department of Medical Statistics, University Hospital of South Manchester, Manchester. 4. Institute of Inflammation and Repair, University of Manchester, Manchester, Chest Clinic, Royal Blackburn Hospital, Haslingden Road, Blackburn, Lancashire Postgraduate School of Medicine and Health, University of Central Lancashire, Preston, Lancashire, UK.
Abstract
SETTING: Drug-induced hepatitis is known to occur in a proportion of patients on treatment for active tuberculosis (TB). DESIGN: We prospectively examined the incidence of drug-induced hepatitis in 2070 patients treated for TB with the standard regimen based on 6 months of rifampicin (R, RMP) and isoniazid (H, INH), with 2 months of initial pyrazinamide (Z, PZA) and ethambutol (E, EMB), over a 30-year period from 1981 to 2010, in Blackburn, UK. RESULTS: Of the 1031 (49.8%) males and 1039 (50.2%) females studied, 451 (21.8%) were White and 1585 (76.6%) were of South Asian origin. Only 34 (1.6%) were of African or other origins. Of the total number of patients treated, 63 (3.0%) had drug-related hepatitis, 26 (5.8%) of whom were White, 37 (2.33%) Asians and 0 other. Incidence was significantly higher in Whites than Asians (OR 2.13, P = 0.008). Incidence increased with increasing age (OR 1.16, P = 0.02). The presumed causative drug was PZA 57%, RMP 32%, INH 11%, EMB 0%. There was no trend of increased hepatitis rates over time. CONCLUSION: Rates of drug-induced hepatitis where change of treatment is required are low in patients treated with standard RHZE-based therapy (3%). Caucasians and older patients were more likely to develop hepatitis than their counterparts.
SETTING:Drug-induced hepatitis is known to occur in a proportion of patients on treatment for active tuberculosis (TB). DESIGN: We prospectively examined the incidence of drug-induced hepatitis in 2070 patients treated for TB with the standard regimen based on 6 months of rifampicin (R, RMP) and isoniazid (H, INH), with 2 months of initial pyrazinamide (Z, PZA) and ethambutol (E, EMB), over a 30-year period from 1981 to 2010, in Blackburn, UK. RESULTS: Of the 1031 (49.8%) males and 1039 (50.2%) females studied, 451 (21.8%) were White and 1585 (76.6%) were of South Asian origin. Only 34 (1.6%) were of African or other origins. Of the total number of patients treated, 63 (3.0%) had drug-related hepatitis, 26 (5.8%) of whom were White, 37 (2.33%) Asians and 0 other. Incidence was significantly higher in Whites than Asians (OR 2.13, P = 0.008). Incidence increased with increasing age (OR 1.16, P = 0.02). The presumed causative drug was PZA 57%, RMP 32%, INH 11%, EMB 0%. There was no trend of increased hepatitis rates over time. CONCLUSION: Rates of drug-induced hepatitis where change of treatment is required are low in patients treated with standard RHZE-based therapy (3%). Caucasians and older patients were more likely to develop hepatitis than their counterparts.
Authors: Aula Abbara; Sarah Chitty; Jennifer K Roe; Rohma Ghani; Simon M Collin; Andrew Ritchie; Onn Min Kon; John Dzvova; Harriet Davidson; Thomas E Edwards; Charlotte Hateley; Matthew Routledge; Jim Buckley; Robert N Davidson; Laurence John Journal: BMC Infect Dis Date: 2017-03-24 Impact factor: 3.090
Authors: Conor D Tweed; Angela M Crook; Evans I Amukoye; Rodney Dawson; Andreas H Diacon; Madeline Hanekom; Timothy D McHugh; Carl M Mendel; Sarah K Meredith; Michael E Murphy; Saraswathi E Murthy; Andrew J Nunn; Patrick P J Phillips; Kasha P Singh; Melvin Spigelman; Genevieve H Wills; Stephen H Gillespie Journal: BMC Infect Dis Date: 2018-07-11 Impact factor: 3.090