The incidence of hepatotoxicity due to anti-tubercular treatment and its associated risk factors in patients with tuberculosis: an analytical cross-sectional study

Abstract

Introduction: Tuberculosis (TB), primarily a pulmonary disease, requires a 6-month regimen of anti-tuberculous drugs. While effective, this treatment can lead to adverse effects, particularly drug-induced liver injury (DILI). This study investigates the incidence, severity, and associated risk factors of hepatotoxicity in TB patients undergoing anti-tubercular treatment (ATT).

Methods: This analytical cross-sectional study was conducted at a tertiary healthcare center over six months. A total of 125 adult TB patients were selected through convenience sampling. Patient number; demographic data, clinical history, and laboratory results were recorded. Hepatotoxicity was graded based on WHO criteria, and correlations with alanine transaminase (ALT) and bilirubin levels were analyzed using SPSS version 22.

Results: The study revealed that 18.4% of patients developed hepatotoxicity, with 5.6% experiencing mild, 4% moderate, 4.8% severe, and 4% life-threatening levels. A moderate positive correlation (r = 0.56) was found between ALT levels and hepatotoxicity grades, while a strong correlation (r = 0.67) was observed with total bilirubin levels.

Statistical Analysis: Significant correlations between liver function markers and hepatotoxicity severity underscore the importance of regular monitoring in TB patients on ATT.

Conclusions: The study highlights the high incidence of hepatotoxicity in TB patients, emphasizing the need for regular liver function monitoring to minimize severe outcomes and optimize treatment strategies.

Keywords: Tuberculosis, anti-tubercular treatment, drug-induced liver injury, hepatitis, adverse drug reactions