Drug-induced liver injury from antituberculous treatment: a retrospective study from a large TB centre in the UK

BMC Infectious Diseases

Research Article

Onn Min Kon¹  Rohma Ghani²  John Dzvova²  Jim Buckley²  Robert N. Davidson²  Charlotte Hateley²  Laurence John²  Harriet Davidson²  Sarah Chitty²  Matthew Routledge²  Thomas E. Edwards²  Andrew Ritchie²  Jennifer K. Roe³  Aula Abbara⁴  Simon M. Collin⁵ 

[1] Department of Chest and Allergy, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK;Department of Infection, Northwick Park Hospital, London North West Healthcare NHS Trust, London, UK;Department of Infection, Northwick Park Hospital, London North West Healthcare NHS Trust, London, UK;Department of Immunology, University College London, London, UK;Department of Infection, Northwick Park Hospital, London North West Healthcare NHS Trust, London, UK;NHLI, Imperial College London, London, UK;School of Social and Community Medicine, University of Bristol, Bristol, UK;

关键词: Tuberculosis;    Drug induced liver injury;    Hepatotoxicity;    Re-introduction regimen;    Risk factors;    Liver failure;   

DOI  :  10.1186/s12879-017-2330-z

 received in 2016-10-11, accepted in 2017-03-18,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundWe describe drug-induced liver injury (DILI) secondary to antituberculous treatment (ATT) in a large tuberculosis (TB) centre in London; we identify the proportion who had risk factors for DILI and the timing and outcome of DILI.MethodsWe identified consecutive patients who developed DILI whilst on treatment for active TB; patients with active TB without DILI were selected as controls. Comprehensive demographic and clinical data, management and outcome were recorded.ResultsThere were 105 (6.9%) cases of ATT-associated DILI amongst 1529 patients diagnosed with active TB between April 2010 and May 2014. Risk factors for DILI were: low patient weight, HIV-1 co-infection, higher baseline ALP, and alcohol intake. Only 25.7% of patients had British or American Thoracic Society defined criteria for liver test (LT) monitoring. Half (53%) of the cases occurred within 2 weeks of starting ATT and 87.6% occurred within 8 weeks. Five (4.8%) of seven deaths were attributable to DILI.ConclusionsOnly a quarter of patients who developed DILI had British or American Thoracic Society defined criteria for pre-emptive LT monitoring, suggesting that all patients on ATT should be considered for universal liver monitoring particularly during the first 8 weeks of treatment.

【 授权许可】

CC BY   
© The Author(s). 2017