title: Weight loss during tuberculosis treatment is an important risk factor for drug-induced hepatotoxicity.
abstract: The objective of this study was to determine the association between weight loss and drug-induced hepatotoxicity (DIH). A retrospective observational study of 192 active tuberculosis (TB) patients consecutively admitted in a tertiary referral TB centre in the Netherlands was conducted. The outcome measure for DIH was defined as hepatotoxicity necessitating interruption of anti-TB drugs. Multivariate logistic regression analysis on interruption of anti-TB drugs was performed, with age, sex, nutritional status, TB disease severity, drug resistance, comorbidity including baseline liver function tests, anti-TB drug regimen, co-medication and addictions as independent risk factors. Anti-TB drugs were interrupted in thirty-one patients (16·1%). The most important risk factor was weight loss of 2 kg or more within 4 weeks during TB treatment (OR 211, 95% CI 36·0, 1232). Other independent risk factors were infection with hepatitis C (OR 19·6, 95% CI 2·4, 164), age over 60 years (OR 18·5, 95% CI 2·3, 151) and multi-drug-resistant TB (OR 8·2, 95% CI 1·3, 53·6). This study shows that weight loss during TB treatment was the most important risk factor for DIH necessitating interruption of anti-TB drugs. Causes of weight loss during TB treatment and the association between weight change and hepatotoxicity need further investigation.
authors.affiliation: Tuberculosis Center, University Medical Center Groningen, PO Box 30002, 9750 RA Haren, The Netherlands. g.warmelink@cvr.umcg.nl
authors.forename: Ina
authors.initials: I
authors.lastname: Warmelink
authors.forename: Nick H
authors.initials: NH
authors.lastname: ten Hacken
authors.forename: Tjip S
authors.initials: TS
authors.lastname: van der Werf
authors.forename: Richard
authors.initials: R
authors.lastname: van Altena
mesh_terms: D000328:Adult; D000367:Age Factors; D000995:Antitubercular Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D005260:Female; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D012189:Retrospective Studies; D012307:Risk Factors; D014376:Tuberculosis / Q000188:drug therapy*; D018088:Tuberculosis, Multidrug-Resistant; D015431:Weight Loss / Q000502:physiology*
chemical_list: D000995:Antitubercular Agents