Risk factors for hepatotoxicity induced by antituberculosis drugs.

F M Devoto, C González, R Iannantuono, H A Serra, C D González, C Sáenz
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Abstract

To evaluate the risk factors involved in antituberculosis treatment-induced hepatotoxicity. In a retrospective study we analyzed the rate of drug-induced hepatotoxicity in a sample of 456 patients. Patients received a combination of drugs including isoniazid, rifampin, pirazinamide and streptomycin or ethambutol. The association among hepatotoxicity and several risk factors (age, sex, alcoholism and HIV infection) was studied by univariate methods, stratified analysis and the multiple logistic regression model. Signs of liver injury were found in 9.86% of the treated patients. In the logistic model, the adjusted odds ratios (OR) and significance were found as follows: a) for alcoholism, OR = 17.31 (95% CI: 6.35-47.16), p < 0.001; b) for HIV infection, OR = 3.23 (95% CI: 1.47-7.11), p = 0.003 and c) for female sex, OR = 2.44 (95% CI: 1.22-4.86), p = 0.011. Age was not significantly associated with hepatotoxicity. Alcoholism, HIV infection and female sex were associated with an increased risk of hepatotoxicity in this study.

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抗结核药物引起肝毒性的危险因素。
目的评价抗结核治疗引起肝毒性的危险因素。在一项回顾性研究中,我们分析了456例患者样本中药物性肝毒性的发生率。患者接受包括异烟肼、利福平、吡嗪酰胺、链霉素或乙胺丁醇在内的联合用药。通过单变量方法、分层分析和多元logistic回归模型研究肝毒性与几个危险因素(年龄、性别、酒精中毒和HIV感染)之间的关系。9.86%的患者出现肝损伤征象。在logistic模型中,调整后的优势比(OR)和显著性发现如下:a)酒精中毒,OR = 17.31 (95% CI: 6.35-47.16), p < 0.001;b) HIV感染,OR = 3.23 (95% CI: 1.47-7.11), p = 0.003; c)女性,OR = 2.44 (95% CI: 1.22-4.86), p = 0.011。年龄与肝毒性无显著相关性。在这项研究中,酒精中毒、HIV感染和女性性行为与肝毒性风险增加有关。
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