Drug-induced Hepatotoxicity of Anti-tuberculosis Drugs and Their Serum Levels.
10.3346/jkms.2015.30.2.167
- Author:
Ina JEONG
1
;
Jong Sun PARK
;
Young Jae CHO
;
Ho Il YOON
;
Junghan SONG
;
Choon Taek LEE
;
Jae Ho LEE
Author Information
1. Department of Internal Medicine, National Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Therapeutic Drug Monitoring;
Hepatotoxicity;
Tuberculosis
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Alanine Transaminase/blood;
Antitubercular Agents/adverse effects/*blood/therapeutic use;
Aspartate Aminotransferases/blood;
Drug-Induced Liver Injury/*blood;
Ethambutol/adverse effects/blood/therapeutic use;
Female;
Humans;
Isoniazid/adverse effects/blood/therapeutic use;
Liver/*pathology;
Liver Function Tests;
Male;
Middle Aged;
Pyrazinamide/adverse effects/blood/therapeutic use;
Retrospective Studies;
Rifampin/adverse effects/blood/therapeutic use;
Tuberculosis, Pulmonary/drug therapy;
Young Adult
- From:Journal of Korean Medical Science
2015;30(2):167-172
- CountryRepublic of Korea
- Language:English
-
Abstract:
The correlation between serum anti-tuberculosis (TB) drug levels and the drug-induced hepatotoxicity (DIH) remains unclear. The purpose of this study was to investigate whether anti-TB DIH is associated with basal serum drug levels. Serum peak levels of isoniazid (INH), rifampicin (RMP), pyrazinamide (PZA), and ethambutol (EMB) were analyzed in blood samples 2 hr after the administration of anti-TB medication. Anti-TB DIH and mild liver function test abnormality were diagnosed on the basis of laboratory and clinical criteria. Serum anti-TB drug levels and other clinical factors were compared between the hepatotoxicity and non-hepatotoxicity groups. A total of 195 TB patients were included in the study, and the data were analyzed retrospectively. Seventeen (8.7%) of the 195 patients showed hepatotoxicity, and the mean aspartate aminotransferase/alanine aminotransferase levels in the hepatotoxicity group were 249/249 IU/L, respectively. Among the 17 patients with hepatotoxicity, 12 showed anti-TB DIH. Ten patients showed PZA-related hepatotoxicity and 2 showed INH- or RMP-related hepatotoxicity. However, intergroup differences in the serum levels of the 4 anti-TB drugs were not statistically significant. Basal serum drug concentration was not associated with the risk anti-TB DIH in patients being treated with the currently recommended doses of first-line anti-TB treatment drugs.
