Effect of scheduled monitoring of liver function during anti-Tuberculosis treatment in a retrospective cohort in China.
BACKGROUND
Data on effect of regular liver function monitoring during anti-TB treatment is limited in China. This study aimed to evaluate the effects of scheduled liver function monitoring on identification of asymptomatic liver damage and anti-TB treatment outcomes during anti-TB treatment.


METHODS
A retrospective analysis was performed based on a national-level cohort study. A total of 273 patients developing liver dysfunction were divided into two groups, 111 patients who were diagnosed through scheduled liver function test within two months after initiation of anti-TB treatment formed scheduled monitoring group, others who were diagnosed due to developing symptoms formed passive detection group (n = 162). The two groups were compared through clinical features, prognosis of liver dysfunction and impact on anti-TB treatment using propensity score weighting analysis.


RESULTS
33.3% of 273 patients did not have any clinical symptoms, including 8 with severe hepatotoxicity. 1.8% in scheduled monitoring group and 11.1% in passive detection group required hospitalization (P = 0.004). Regarding the prognosis of liver dysfunction, most patients recovered, no death happened in scheduled monitoring group while 3 died in passive detection group. In terms of impact on anti-TB treatment, 35.1% in scheduled monitoring group and 56.8% in passive detection group changed their anti-TB treatment (P = 0.001).


CONCLUSIONS
Scheduled monitoring is effective in identifying asymptomatic liver damage, reducing hospitalization rate and improving compliance of anti-TB treatment.
Department of Epidemiology and Bio-statistics, School of Public Health, Peking University Health Science Centre, Haidian District, Beijing 100191, China.
Shanshan
S
Wu
Yinyin
Y
Xia
Xiaozhen
X
Lv
Yuan
Y
Zhang
Shaowen
S
Tang
Zhirong
Z
Yang
Dehua
D
Tu
Peiyuan
P
Deng
Shiming
S
Cheng
Xiaomeng
X
Wang
Yanli
Y
Yuan
Feiying
F
Liu
Daiyu
D
Hu
Siyan
S
Zhan
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000009:adverse effects* / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000209:etiology*; D002648:Child; D002681:China; D015331:Cohort Studies; D016903:Drug Monitoring; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008099:Liver / Q000187:drug effects*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014376:Tuberculosis / Q000188:drug therapy*
D000995:Antitubercular Agents