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Weight loss during tuberculosis treatment is an important risk factor for drug-induced hepatotoxicity

2010; Cambridge University Press; Volume: 105; Issue: 3 Linguagem: Inglês

10.1017/s0007114510003636

1475-2662

Ina Warmelink, Nick H.T. ten Hacken, Tjip S. van der Werf, Richard van Altena,

Liver Disease Diagnosis and Treatment

The objective of this study was to determine the association between weight loss and drug-induced hepatotoxicity (DIH). A retrospective observational study of 192 active tuberculosis (TB) patients consecutively admitted in a tertiary referral TB centre in the Netherlands was conducted. The outcome measure for DIH was defined as hepatotoxicity necessitating interruption of anti-TB drugs. Multivariate logistic regression analysis on interruption of anti-TB drugs was performed, with age, sex, nutritional status, TB disease severity, drug resistance, comorbidity including baseline liver function tests, anti-TB drug regimen, co-medication and addictions as independent risk factors. Anti-TB drugs were interrupted in thirty-one patients (16·1 %). The most important risk factor was weight loss of 2 kg or more within 4 weeks during TB treatment (OR 211, 95 % CI 36·0, 1232). Other independent risk factors were infection with hepatitis C (OR 19·6, 95 % CI 2·4, 164), age over 60 years (OR 18·5, 95 % CI 2·3, 151) and multi-drug-resistant TB (OR 8·2, 95 % CI 1·3, 53·6). This study shows that weight loss during TB treatment was the most important risk factor for DIH necessitating interruption of anti-TB drugs. Causes of weight loss during TB treatment and the association between weight change and hepatotoxicity need further investigation.