Short-course chemotherapy including combination therapy of rifampicin and isoniazid has shown evidence of effectiveness in the treatment of tuberculosis. However, it causes certain adverse effects, one of which is hepatotoxicity. Numerous risk factors have been found to be correlated with drug-induced liver injury (DILI) in general population. 

The objective of the current study was to evaluate the prevalence of drug-induced hepatitis and the risk factors related to DILI among the patients of pulmonary tuberculosis in Indian patients. The study included cohort of 3900 tuberculosis patients who were undergoing anti-tubercular therapy. Among these, 150 patients developed DILI due to short-course chemotherapy. A total of 30 cases were being followed up in the hospital and other 120 were referred for the management of drug-induced hepatitis from the primary health centers. The American Thoracic Society recommended criteria for diagnosis for DILI. Examination of various risk factors was done for the development of DILI. 

The outcome revealed that patients had low levels of serum albumin levels with multiple co-morbid conditions. Daily consumption of alcohol, female gender and more extensive disease were considered to be independent risk factors for the development of DILI.

Thus, the study concluded that advanced age, hypoalbuminemia, regular alcohol consumption and advanced nature of the disease are independent risk factors for the development of DILI. The presence of one or more of these risk factors can lead to the development of hepatitis in patients with pulmonary tuberculosis.

Source: Gaude GS, Chaudhury A, Hattiholi J. Drug-induced hepatitis and the risk factors for liver injury in pulmonary tuberculosis patients. J Family Med Prim Care. 2015 Apr-Jun;4(2):238-43.