Anti-tuberculosis drug inducd hepatitis - a Sri Lankan experience.

Autor: Senaratne WV; Chest Hospital, Welisara, Sri Lanka., Pinidiyapathirage MJ, Perera GA, Wickremasinghe AR
Jazyk: angličtina
Zdroj: The Ceylon medical journal [Ceylon Med J] 2006 Mar; Vol. 51 (1), pp. 9-14.
DOI: 10.4038/cmj.v51i1.1369
Abstrakt: Objective: To assess the incidence of anti-tuberculosis (TB) drug induced hepatitis (AIH) in Sri Lankan patients, determine risk factors of AIH, and to address management options in AIH.
Design: A prospective study.
Setting: Chest Hospital, Welisara, Sri Lanka, from April 2001 to April 2002.
Patients: Seven hundred and eighty three patients with a confirmed diagnosis of TB and resident in the Colombo and Gampaha districts who presented to Chest Hospital, Welisara, Sri Lanka.
Methods: WHO recommended treatment was commenced in all cases. AIH was diagnosed when patients complained of decreased appetite with nausea or vomiting and elevated serum bilirubin (SB; >1.1 mg/dL) or elevated serum alanine transferase (ALT; > 3 times upper limit of normal).
Results: Of 783 enrolled patients, 74 (9.5%) developed AIH, the majority (58%) developing AIH within the first 2 weeks of the intensive phase of treatment. AIH was more common among patients over 60 years (p = 0.018), who developed pulmonary TB (p = 0.028), and in patients weighing 33-55 kg (p = 0.004). Age, weight and rifampicin overdosage were significant predictors of AIH. Of the 74 AIH patients, standard treatment was restarted in 60, treatment modified in six, two defaulted and six died.
Conclusions: The incidence of AIH in Sri Lanka is 9.5% in treated patients. AIH was associated with age, low body weight and rifampicin overdosage.
Databáze: MEDLINE