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Antituberculosis drug‐related liver dysfunction in chronic hepatitis B infection
Author(s) -
Wong WaiMan,
Wu PuiChee,
Yuen ManFung,
Cheng ChiChung,
Yew WingWai,
Wong PoonChuen,
Tam CheukMing,
Leung ChiChiu,
Lai ChingLung
Publication year - 2000
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510310129
Subject(s) - medicine , gastroenterology , liver dysfunction , alanine transaminase , liver function tests , liver function , hepatitis b , liver injury , incidence (geometry) , hepatitis b virus , drug , aspartate transaminase , hepatitis , viral hepatitis , immunology , pharmacology , virus , biochemistry , physics , alkaline phosphatase , chemistry , optics , enzyme
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.