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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Infectious Diseases 1/2017

Drug-induced liver injury from antituberculous treatment: a retrospective study from a large TB centre in the UK

Zeitschrift:
BMC Infectious Diseases > Ausgabe 1/2017
Autoren:
Aula Abbara, Sarah Chitty, Jennifer K. Roe, Rohma Ghani, Simon M. Collin, Andrew Ritchie, Onn Min Kon, John Dzvova, Harriet Davidson, Thomas E. Edwards, Charlotte Hateley, Matthew Routledge, Jim Buckley, Robert N. Davidson, Laurence John
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12879-017-2330-z) contains supplementary material, which is available to authorized users.

Abstract

Background

We describe drug-induced liver injury (DILI) secondary to antituberculous treatment (ATT) in a large tuberculosis (TB) centre in London; we identify the proportion who had risk factors for DILI and the timing and outcome of DILI.

Methods

We identified consecutive patients who developed DILI whilst on treatment for active TB; patients with active TB without DILI were selected as controls. Comprehensive demographic and clinical data, management and outcome were recorded.

Results

There were 105 (6.9%) cases of ATT-associated DILI amongst 1529 patients diagnosed with active TB between April 2010 and May 2014. Risk factors for DILI were: low patient weight, HIV-1 co-infection, higher baseline ALP, and alcohol intake. Only 25.7% of patients had British or American Thoracic Society defined criteria for liver test (LT) monitoring. Half (53%) of the cases occurred within 2 weeks of starting ATT and 87.6% occurred within 8 weeks. Five (4.8%) of seven deaths were attributable to DILI.

Conclusions

Only a quarter of patients who developed DILI had British or American Thoracic Society defined criteria for pre-emptive LT monitoring, suggesting that all patients on ATT should be considered for universal liver monitoring particularly during the first 8 weeks of treatment.
Zusatzmaterial
Additional file 1: Table S1. Characteristics of pDILI. This table contains details of the 105 patients including the kinetics of pDILI, symptoms at presentation, initial regimen, management and overall outcome. (DOCX 20 kb)
12879_2017_2330_MOESM1_ESM.docx
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