Tuberculosis (TB) is aprotuberant health problem in various developing countries including India. Thechallenge in the treatment of TB lies in the need of long duration of thetreatment, various drug administration, and toxicities connected to them. An importantcomplication, associated with ATT is drug-induced liver injury (DILI). Thechallenge in managing tuberculosis is supplementary compounded by the liverinjury allied with anti-tubercular treatment (ATT) drugs.

The significance inmanaging patients of ATT-induced hepatotoxicity lies in the fact that onlythese hepatotoxic first line drugs have maximum effectiveness in the treatmentof TB.

DILI is not an unusualaccompaniment of ATT. Its significance is more so in the India, where TB is theforemost epidemiological problem.

TB and DILI have gainedsuch importance in view of the multiple co-infections. Effective managementcalls for superior knowledge and extensive awareness and rapid identificationof the problem with a proper referral. However much has been said and done,there are several areas, which require further understanding. Livertransplantation and posttransplant treatment options require further study.Efficient management policies with second line agents or newer non-hepatotoxicfirst line congeners will help the problem in a long way. As physicians, quickidentification of DILI in itself goes a long way in preventing morbidity andmortality.

Source: Int J Basic ClinPharmacol 2015;4:397-403