Publication:

Incidence of hepatotoxicity in directly observed treatment short course

Background Antitubercular treatment induced hepatotoxicity usually has benign course, but may result in serious morbidity and even mortality. This study was undertaken to determine the incidence of hepatotoxicity in intermitted regimens directly observed treatment, short course (DOTS) and to evaluate the risk factors such as age, sex, nutritional status, disease extent, in the development of antitubercular drug induced hepatotoxicity in intermitted regimens (DOTS).

Methods This was an observational study. All adults and adolescents above 15 years of age and weight more than 30 kilogramss, of either sex, on antitubercular treatment under intermitted regimens (DOTS), coming to chest and tuberculosis. Out-patient department of Dr. D.Y. Patil, hospital and research centre, Navi Mumbai, India, were included. Statistical analysis based on t- test done, predictability calculated to know the significance of study.

Results 50 patients at random on intermitted regimens (DOTS) of antitubercular treatment. Majority (52%) were aged between 15-30 years. There were 24 (48%) males and 26 (52%) females. Serum bilirubin show a rise mean values between 2nd week (SD±053) p-value<0001(significant). Serum glutamic-pyruvic transaminase (SGPT) values show a rise in mean values between 2nd week (SD ±17.56) 4th week (SD±35.37) followed by fall in 6th week, p-value<001(significant), Serum glutamic-oxaloacetic transaminase (SGOT) value show a rise in mean values between 2nd week (SD±14.85) and 6th week (SD±26.18) followed by fall in 8th week, p-value<0001(significant). Mean serum albumin values show a rise in 2nd week (SD±0.53) and fall in the 4th week (SD±0.56) followed by a rise at 6th and 8th week, p-value<0001 (significant). Mean total protein value showed a fall from 2nd week (SD±1.16) to 8th week (SD±0.93) p-value<0001(significant).

Conclusions Patients on antitubercular regimen should be educated about symptomatology related to hepatotoxicity, and they should be advised to consult the physician if symptoms occur. This will ensure reduction in dependency on repeated biochemical examination and also reduce patient’s suffering.