The current study aimed to evaluate the clinical characteristics and the risk factors associated with anti-tuberculosis (anti-TB) drug-induced liver injury (DILI). This study recruited 140 hospitalized patients diagnosed with anti-TB DILI during January 2009 to December 2015. They assessed the baseline characteristics and performed regular follow-up up to the 24th week to determine the possible risk factors related to anti-TB DILI.

Among the total enrolled patients, 20.7% were diagnosed with grades 4–5 DILI and 79.3% with grades 1–3 DILI, and the study population was 58.6% male and 41.4% female patients. Female patients were remarkably more likely to be diagnosed with grades 4–5 DILI in comparison to grades 1–3 DILI (58.6% vs. 36.9%). Grades 4–5 DILI was more prevalent in patients treated with a multidrug anti-TB regimen (86.2% vs. 68.5%). A substantial number of patients who reinitiated anti-TB therapy suffered severe liver injury in comparison to patients with grades 1–3 DILI (41.4% vs. 10.8%). Laboratory examinations showed remarkably higher values for total bilirubin (TBL), International normalized ratio (INR), and Hy’s law in the grades 4–5 group than in the grades 1–3 group.

Thus, the study concluded that risk factors correlated with the severity of anti-TB DILI are female gender, combination therapy for antitubercular drugs (isoniazid, rifampicin and pyrazinamide), re-challenge.

Source: Zhao H, Wang Y, Zhang T, Wang Q, Xie W. Drug-Induced Liver Injury from Anti-Tuberculosis Treatment: A Retrospective Cohort Study. Med Sci Monit. 2020;26:e920350. Published 2020 Mar 7.