ANTI-TUBERCULAR DRUG INDUCED HEPATOTOXICITY: ASSOCIATED RISK FACTORS UNDER RNTCP-DOTS PULMONARY TUBERCULOSIS PATIENTS.

Introduction: Prospective study conducted among 263 patients for evaluation of Drug-induced hepatotoxicity (DIH) to know predisposing factors for DIH diagnosed cases of pulmonary tuberculosis patients under anti-tubercular therapy (ATT) as per Revised National Tuberculosis Control Program (RNTCP) on short term regimen at Chatrapati Shivaji Subharti Hospital attached Subharti Medical College, Meerut, Patients attending, Respiratory Medicine Out Patient department (OPD) and referred patients from Urban Health Training Centre and Rural Health Training Centre with pretreatment liver function test (LFT) were assessed. Patients and methods: Before initiation of first line ATT (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol, and Streptomycin), LFT and other relevant investigations were carried out. Overnight fasting blood samples were collected for LFT on 2nd, 4th and 8th week during treatment for assessment of disease status. A total of 263 patients, 174 male and 89 female with mean age of 41 years were assessed. Results: A total of 35 patients (13.30%) developed DIH. The Body mass index (BMI) and albumin was found significantly low compared to control (P<0.01). The chest radiograph recorded clear cavitory lesions. Results highlight that the age group 41-50 years is at high risk of DIH (31.43%), furthermore it is more prevalent among male (68.57%) than female (31.43%) counterpart. Conclusion: Old age male, baseline hypoalbuminemia, low BMI, malnutrition and extensive disease states are independent risk factors observed in present study.