Volume : 10, Issue : 05, May – 2023
09.ANTI-TUBERCULOSIS DRUG INDUCED HEPATOTOXICITY
Liya S Saji*, Mrs. Soumya R V, Ms. Jyothi B N, Ms. Revathi Mohan, Dr. Prasobh G R
Tuberculosis (TB) is a chronic bacterial infection caused by Mycobacterium tuberculosis complex, most commonly by Mycobacterium tuberculosis, and is usually characterized pathologically by the formation of granulomas. The cornerstone of TB management is a 6- month course of using anti-TB drugs where isoniazid, rifampicin, pyrazinamide, and ethambutol are taken for 2 months in the intensive phase followed by a fourth month use of isoniazid and rifampicin in the continuous phase of managing protocols of the disease. One of the adverse effects affecting TB treatment outcome is anti-TB drug induced hepatotoxicity. Among the first-line anti-TB drugs, isoniazid, rifampicin, and pyrazinamide are known to cause hepatotoxicity, but pyrazinamide attribute to a higher percentage for the drug induced liver toxicity compared to the other drugs. The treatment regimen of tuberculosis can be tailored on patient’s needs, mycobacterial tuberculosis resistance pattern, and location of the disease. Even though the first-line anti-TB drugs are effective, their liver toxicity may lead to drug interruption; which can in turn be the cause for the development of Multidrug Resistant Tuberculosis (MDR-TB). The simultaneous use of a number of drugs for a prolonged period of time, for the treatment of TB, further complicates the drug-induced toxicity problem.
Cite This Article:
Please cite this article in press Liya S Saji et al, Anti-Tuberculosis Drug Induced Hepatotoxicity., Indo Am. J. P. Sci, 2023; 10 (05).
Number of Downloads : 10
1. DR. Mandan Kaushik. Textbook of pathophysiology: page no: 382.
2. Lienhardt C et al. Efficacy and Safety of a four-drug fixed dose combination regimen compared with separate drugs for treatment of pulmonary TB. The Study C randomized controlled trial. JAMA. 2011; 305:1415.
3. Lin HH et al. Association between tobacco smoking and active TB in Taiwan: prospective cohort study Am J Respir Crit Care Med. 2009;180:475.
4. Mazurek GH et al. Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection United States, 2010.
5. World Health Organization. Global tuberculosis report 2021.
6. Peloquin CA Berning SE. infection caused by Mycobacterium tuberculosis. Ann pharmacother 1994; 28:72.
7. Daniel TM et al Tuberculosis. In Wilson the et al eds. Harrison’s principles of internal medicine. 12th edition New York MC Grawthill 1991:637.
8. Barbara G. Wells, Joseph T. Dipiro, Terry L. Schwinghammer, Cecily V. Dipiro. Pharmacotherapy handbook: seventh edition. page no: 532-543.
9. Roger walker and Cate Whittlesea. Clinical pharmacy and therapeutics: 5th edition. Page no:608-618
10. Hobby, G.L.; Lenert, T.F. The in vitro action of antituberculosis agents against multiplying and non-multiplying microbial cells. Am. Rev. Tuberc, 1957, 76, 1031-1048.
11. Dover, L.G.; Geoffrey, D. Current Status and Research Strategies in Tuberculosis Drug Development. J. Med. Chem., 2011, 54, 6157-6165.
12. Kolyva, A.S.; Karakousis, P.C. Old and New TB Drugs: Mechanisms of Action and Resistance. Understanding Tuberculosis – New Approaches to Fighting Against Drug Resistance. In. Tech., 2012, 12, 209-232.
13. Kaona, F.A.; Tuba, M.; Siziya, S.; Sikaona, L. An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment. BMC Public Health, 2004, 4, 68.
14. The Global Tuberculosis Program. www.who.int/tb/about/en (Accessed on May 23, 2015).
15. Shah, N.S.; Wright, A.; Bai, A.H.; Barrera, L. Worldwide Emergence of Extensively Drug- resistant Tuberculosis. Emerg. Infect. Dis., 2006, 13, 380-387.
16. Revised National Tuberculosis Control Programme DOTS-Plus Guidelines, Central TB Division-Directorate General of Health Services, Ministry of Health & Family Welfare Nirman Bhavan: New Delhi, 2010.
17. Veziris, N.; Pernot, T.C.; Aubry, A.; Jarlier. V. Fluoroquinolone containing third-line regimen against Mycobacterium tuberculosis in vivo. Antimicrobial Agents Chemother., 2003, 10, 3117-3122.
18. WHO. International Monitoring of Adverse Reactions to Drugs: Adverse Reaction Terminology. Uppsala: WHO Collaborating Centre for International Drug Monitoring, 1992.
19. Younossian AB, Rochat T, Ketterer JP, Wacker J, Janssens JP. High hepatotoxicity of pyrazinamide and ethambutol for treatment of latent tuberculosis. Eur. Respir. J. 2005; 26: 462–4.
20. Singla R., Sharma S.K., Mohan A. Evaluation of risk factors for antituberculosis treatment induced hepatotoxicity. 2010; 132:81–86.
21. Sarich TC, Youssefi M, Zhou T, Adams SP, Wall RA, Wright JM. Role of hydrazine in the mechanism of isoniazid hepatotoxicity in rabbits. Arch. Toxicol. 1996; 70: 835–40.
22. From the Centres for Disease Control and Prevention. Fatal and severe hepatitis associated with rifampin and pyrazinamide for the treatment of latent tuberculosis infection – New York and Georgia, 2000. JAMA 2001; 285: 2572–3.
23. Steele M.A., Burk R.F., DesPrez R.M. Toxic hepatitis with isoniazid and rifampin. A meta- analysis. 1991; 99:465–471.
24. Treatment of Tuberculosis: Guidelines. 4th ed. WHO/HTM/TB/2009.420.
25. Nolan C.M., Goldberg S.V., Buskin S.E. Hepatotoxicity associated with isoniazid preventive therapy: a 7-year survey from a public health tuberculosis clinic. J Am Med Assoc. 1999; 281:1014–1018.