Assessment of risk factors for anti tuberculous drug induced hepatotoxicity

Objectives: to assess the risk factors in adults for hepatotoxicity caused by different antituberculous (tb) drugs. material and methods: this observational descriptive study was conducted in medical ward and out patient department of naseer teaching hospital,peshawar and khyber teaching hospital,peshawar from august 2007 to june 2008. fifty diagnosed patients of tb receiving first line anti tb drugs with normal pretreatment liver functions were monitored clinically and biochemically. their data was collected on proforma. amongst those who developed hepatotoxicity,the frequency of common risk factors was calculated. results: five patients (10%) developed hepatotoxicity,observed mostly (80%) within 2 weeks of initiation of treatment. among those who developed hepatotoxicity,majority were female of young age (< 35 years) and had sputum smear positive (30%) for acid fast bacilli. nutritional status,assessed by bmi (kg/m2) and serum albumin levels were other predisposing risk factors. most patients were anemic with low hemoglobin levels. conclusion: anti tuberculosis drug induced hepatitis is significantly more frequent in patients with hepatotoxicity risk factors. early recognition and revision of dose administration needs to be proposed at least for these risk groups.