Antituberculosis drug-related liver dysfunction in chronic hepatitis B infection

Hepatology. 2000 Jan;31(1):201-6. doi: 10.1002/hep.510310129.

Abstract

Liver toxicity is a common side effect of antituberculosis (anti-TB) drugs. We studied the differences in liver dysfunction observed during anti-TB treatment between hepatitis B virus carriers (HBV) and noncarriers. Three hundred twenty-four patients on anti-TB drugs were recruited and followed up for 1 year. Forty-three patients with HBV and 276 non-HBV patients were included for analysis. Liver function tests and viral markers were monitored monthly. Liver biopsy was requested whenever the alanine transaminase (ALT) was persistently abnormal. Eighty-six HBV carriers who were not given anti-TB drugs were chosen as a second control and evaluated prospectively. The incidence of liver dysfunction was significantly higher in HBV carriers given anti-TB drugs (34.9%) when compared to noncarriers (9.4%, P <.001) and with HBV carriers not given anti-TB drugs (8.1%, P <.001). For patients given anti-TB drugs, HBV carriers who developed liver dysfunction were younger (P =.011) and had more severe liver injury compared with noncarriers (P =.008). By multiple logistic regression analysis, age (P =.002) and hepatitis B infection (P <.001) were the only 2 significant risk factors for hepatotoxicity related to anti-TB therapy.

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Antitubercular Agents / adverse effects*
  • Aspartate Aminotransferases / blood
  • Biopsy
  • Chemical and Drug Induced Liver Injury*
  • DNA, Viral / blood
  • Female
  • Hepatitis B e Antigens / blood
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / virology
  • Humans
  • Liver / pathology
  • Liver / physiopathology
  • Liver Diseases / pathology
  • Liver Diseases / physiopathology
  • Logistic Models
  • Male
  • Middle Aged

Substances

  • Antitubercular Agents
  • DNA, Viral
  • Hepatitis B e Antigens
  • Aspartate Aminotransferases
  • Alanine Transaminase