Antitubercular drug induced liver injury among tuberculosis patients in central Ethiopia

Tuberculosis (TB) is a curable disease that can be treated with antitubercular (anti-TB) drugs that have markedly reduced mortality due to the disease. However, the drugs may cause liver injury, which is associated with increased morbidity due to acute liver failure, disease progression, and drug resistance. There is a scarcity of evidence on the prevalence and predictors of anti-TB drug-induced liver injury (ATDILI). The aim of this study is to the assess prevalence, predictors, and clinical features of ATDILI in the health centers of Hossana town, Central Ethiopia. In a prospective cohort study, newly diagnosed TB patients (N = 219) receiving first-line anti-TB drugs were enrolled in three selected health centers in Hossana town, Central Ethiopia. Liver function tests were assessed before and four and eight weeks after drug treatment initiation. Patients that had abnormal liver biochemistry prior to treatment and patients positive for either hepatitis B or C viral antibody were excluded. Thirty-five study participants (16.0%) developed ATDILI. Two of them (5.7%) had severe ATDILI. Nausea, vomiting, and anorexia were the most frequently observed symptoms. In multivariable analysis, ATDILI was significantly associated with gender (adjusted odds ratio, AOR = 2.57, 95% CI = 1.11-5.91, P = 0.027), age (AOR = 1.05, 95% CI = 1.01-1.10, P = 0.019), body mass index (AOR = 0.81, 95% CI = 0.69-0.95, P = 0.009), and HIV status (AOR = 6.73, 95% CI = 1.81-25.09, P = 0.005). The results of the study suggest that the prevalence of ATDILI is high among TB patients getting treatment in the health centers in Hossana town, Central Ethiopia. Thus, patients who are female, older, have a low body mass index, and are HIV positive should have their liver function regularly monitored to reduce ATDILI.