Petros Zelalem, Tamirat Anteneh, Assefa Wondimu
Department of Pharmacy, College of Medicine and Health Sciences, Wachemo University, Hosaina, Ethiopia.
Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Sci Rep. 2025 Aug 25;15(1):31309. doi: 10.1038/s41598-025-15855-3.
Tuberculosis (TB) is a curable disease that can be treated with antitubercular (anti-TB) drugs that have markedly reduced mortality due to the disease. However, the drugs may cause liver injury, which is associated with increased morbidity due to acute liver failure, disease progression, and drug resistance. There is a scarcity of evidence on the prevalence and predictors of anti-TB drug-induced liver injury (ATDILI). The aim of this study is to the assess prevalence, predictors, and clinical features of ATDILI in the health centers of Hossana town, Central Ethiopia. In a prospective cohort study, newly diagnosed TB patients (N = 219) receiving first-line anti-TB drugs were enrolled in three selected health centers in Hossana town, Central Ethiopia. Liver function tests were assessed before and four and eight weeks after drug treatment initiation. Patients that had abnormal liver biochemistry prior to treatment and patients positive for either hepatitis B or C viral antibody were excluded. Thirty-five study participants (16.0%) developed ATDILI. Two of them (5.7%) had severe ATDILI. Nausea, vomiting, and anorexia were the most frequently observed symptoms. In multivariable analysis, ATDILI was significantly associated with gender (adjusted odds ratio, AOR = 2.57, 95% CI = 1.11-5.91, P = 0.027), age (AOR = 1.05, 95% CI = 1.01-1.10, P = 0.019), body mass index (AOR = 0.81, 95% CI = 0.69-0.95, P = 0.009), and HIV status (AOR = 6.73, 95% CI = 1.81-25.09, P = 0.005). The results of the study suggest that the prevalence of ATDILI is high among TB patients getting treatment in the health centers in Hossana town, Central Ethiopia. Thus, patients who are female, older, have a low body mass index, and are HIV positive should have their liver function regularly monitored to reduce ATDILI.
结核病（TB）是一种可治愈的疾病，可用抗结核药物进行治疗，这些药物已显著降低了该疾病导致的死亡率。然而，这些药物可能会引起肝损伤，这与急性肝衰竭、疾病进展和耐药性导致的发病率增加有关。关于抗结核药物性肝损伤（ATDILI）的患病率和预测因素的证据很少。本研究的目的是评估埃塞俄比亚中部霍萨纳镇各健康中心ATDILI的患病率、预测因素和临床特征。在一项前瞻性队列研究中，埃塞俄比亚中部霍萨纳镇三个选定的健康中心纳入了219名接受一线抗结核药物治疗的新诊断结核病患者。在开始药物治疗前以及治疗后四周和八周评估肝功能测试。排除治疗前肝功能生化指标异常以及乙肝或丙肝病毒抗体呈阳性的患者。35名研究参与者（16.0%）发生了ATDILI。其中两人（5.7%）患有严重的ATDILI。恶心、呕吐和厌食是最常观察到的症状。在多变量分析中，ATDILI与性别（调整后的优势比，AOR = 2.57，95%可信区间 = 1.11 - 5.91，P = 0.027）、年龄（AOR = 1.05，95%可信区间 = 1.01 - 1.10，P = 0.019）、体重指数（AOR = 0.81，95%可信区间 = 0.69 - 0.95，P = 0.009）和HIV感染状况（AOR = 6.73，95%可信区间 = 1.81 - 25.09，P = 0.005）显著相关。研究结果表明，在埃塞俄比亚中部霍萨纳镇各健康中心接受治疗的结核病患者中，ATDILI的患病率很高。因此，女性、年龄较大、体重指数较低且HIV阳性的患者应定期监测肝功能，以降低ATDILI的发生。
