Prevention and Monitoring of Hepatotoxicity among Patients Receiving Antituberculosis Medications

Abstract

Antituberculosis therapy frequently causes hepatotoxicity. The study is to evaluate the appropriateness of liver function monitoring during antituberculosis therapy. Two hundred forty five patients treated with antituberculosis agents were included. Abnormal baseline liver function (LFT) was the most significant risk factor for developing hepatotoxicity during the therapy (adjusted OR 23.48; 95% CI: 9.74-56.61). However, the baseline aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were only checked in 76.2% and 75.4% subjects in the hepatotoxic group; and even lower to 58.5% and 57.8% for the non-hepatotoxic group. Although smoking, severe drinking, age, gender and concurrent diseases were significant risk factors, the logistic regression showed that only abnormal baseline LFT (adjusted OR 2.21; 95% CI: 1.22-4.02) and age (adjusted OR 1.02; 95% CI: 1.01-1.04) were determinants of patients receiving follow-up liver function tests (LFTs). Effective strategies to improve the monitoring of liver function should be established to ensure patient safety.