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Risk Factors and Clinical Predictors of Drug-Induced Hepatotoxicity in Patients Receiving First-Line
Hammad Khan1, Momna Arif2,3, Farzana Aftab4
1Intensive Care Unit, Hayatabad Medical Complex, Peshawar, PAK.
Cureus
|July 12, 2026
Summary
Drug-induced liver injury during tuberculosis treatment is linked to older age, female sex, alcohol use, viral hepatitis, and poor nutrition. Identifying these risk factors improves patient safety and treatment outcomes.
Area of Science:
- Hepatology
- Infectious Diseases
- Pharmacology
Background:
- Drug-induced hepatotoxicity is a significant concern in anti-tuberculosis (TB) therapy.
- It can negatively impact treatment safety and patient outcomes.
Purpose of the Study:
- To identify and evaluate clinical, laboratory, and nutritional factors associated with drug-induced hepatotoxicity.
- Focus on patients undergoing first-line anti-TB treatment.
Main Methods:
- Prospective observational study of 220 adult TB patients in Peshawar, Pakistan.
- Collected data on demographics, comorbidities, liver function tests (ALT, AST), and nutritional biomarkers (albumin, prealbumin, total protein).
- Assessed hepatotoxicity using defined ALT/AST levels and employed statistical analyses including multivariate logistic regression.
Main Results:
- Hepatotoxicity occurred in 17.27% of patients, with varying severity.
- Significant risk factors included age >45 years, female sex, alcohol use, and viral hepatitis.
- Low serum albumin and prealbumin levels were also associated with increased hepatotoxicity risk.
Conclusions:
- Specific clinical, laboratory, and nutritional factors predict drug-induced hepatotoxicity in TB patients.
- These predictors can help identify at-risk individuals for targeted monitoring.
- Further research and targeted strategies are needed to enhance treatment safety.
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