risk factors and pattern of changes in liver enzymes among the patients with anti-tuberculosis drug-induced hepatitis

Background: hepatotoxicity is one of the most frequent adverse events that occurs during tuberculosis treatment and is associated with mortality of 6% - 12% if drugs are continued after the appearance of symptoms. in most of the cases, hepatitis is evident within three months after induction of anti-tuberculosis treatment. objectives: the current study aimed to define the pattern of changes in liver transaminases and the associated risk factors among the patients with anti-tuberculosis drug-induced hepatitis who admitted to boo-ali hospital in zahedan, southeastern iran. patients and methods: the current descriptive cross-sectional study reviewed all files of the patients with anti-tuberculosis drug-induced hepatitis (dih) who referred to boo-ali hospital in zahedan, southeastern iran, in five years. all patients were above 14 years, and were treated with the standard regimen (a combination of isoniazid, rifampin, pyrazinamide, and ethambutol ± streptomycin). hepatotoxicity was defined when the liver transaminases were more than five, the upper limit of normal (uln), or had clinical symptoms with an increase of liver transaminases ≥ 3 uln. results: among the 946 patients with tuberculosis disease (44% men; 56% women), 52 (5.5%) cases had drug-induced hepatotoxicity. only 25% of the patients with anti-tuberculosis drug-induced hepatitis were below 52; 50% of the cases occurred within the first two weeks after the treatment onset. conclusions: anti-tuberculosis drugs-induced hepatotoxicity caused treatment interruption in 5.5% of the patients with tuberculosis. the majority of the patients with dih were above fifty, and 50% the cases occurred during the first two weeks after treatment onset. physicians must carefully and closely monitor such patients.