INCIDENCE AND CHARACTERISTICS OF ANTITUBERCULOSIS DRUGS HEPATOTOXICITY
WITH AND WITHOUT HIV INFECTION IN BANDUNG PERIOD JUNE–OCTOBER 2012
Sumantri A, Djumhana A, Wisaksana R,
Sumantri R
Background. Hepatotoxicity
is one of the complications in the treatment of tuberculosis (Tb). Mainly it
is
caused by the first-line drugs
antituberculosis, and this is
a
clinical obstacle in dealing with Tb treatment. The aims of this study
were to find the incidence and
characateristic of antituberculosis hepatotoxicity in
tuberculosis patients with and without HIV infection.
Method. A
descriptive observational study was conducted in patients who received anti-tuberculosis
treatment at Dr.Hasan Sadikin Hospital and
Bungsu Hospital Bandung, during period
June to October
2012. Hepatotoxicity diagnose based on WHO criteria. Baseline data were gender,
age, type of Tb, body mass index (BMI), albumin, HIV infection, HBsAg,
Anti-HCV, hemoglobin (Hb), total lymphocyte count (TLC), CD4, history of
alcohol consumption and other medications.
Result. One
hundred and twenty patients were recruited, consist of 12 patients with HIV positive and
108 patiens with HIV negative. All patients received
first-line antituberculosis drugs. The overall incidence of
hepatotoxicity is 23.3% (28 of 120 patients), consist of 9 patients
with HIV positive (50%) and 19 patients with HIV negative (18.6%). The event of
hepatotoxicity majority was found during the first two weeks of treatment,
66.7% in HIV patients and 78.9% in non-HIV patients. Based on subgroup
analysis, there were difference characteristics in sex, BMI, albumin, Hb, TLC,
Anti HCV, and alcohol consumption between HIV and non-HIV patients.
Conclusion. Antituberculosis hepatotoxicity incidence tend to
be higher in TB patients co-infected with HIV
than non-HIV infection. The limitation of this study was not to analyze risk
factors associated with hepatotoxicity because of the study sample in HIV group
was not adequate. Needs further study to
identify the risk factors which associated with antituberculosis hepatotoxicity
in patients with and without HIV infection.
Key Word: Tuberculosis, HIV,
anti-tuberculosis hepatotoxicity
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