Risk factor for Rifampicin, Isoniazid and Pyrazinamide induced Hepatitis in Pulmonary Tuberculosis patients

Abstract

Background: Rifampicin, Isoniazid, and Pyrazinamide, key drugs for treating tuberculosis, may lead to drug-induced hepatitis. Patient age, pre-existing liver conditions, and genetics contribute to this risk. Regular liver function monitoring is vital for early detection and intervention. Balancing treatment benefits with potential risks is crucial, emphasizing personalized care and vigilant monitoring. Objective: This retrospective study examines drug-induced liver injury (DILI) during anti-tuberculosis therapy with Rifampicin, Isoniazid, and Pyrazinamide in a cohort of 2000 participants, aiming to identify risk factors and characterize the patient population. Methodology: A retrospective analysis was conducted in the Department of Gastroenterology and Department of Medicine AK CMH/ Sheikh Khalifa Bin Zayed Al Nahyan Hospital Rawalakot on the medical archives of 2000 patients with PTB who were treated with RIF, INH and PZA between November 1, 2020, and August 1, 2021. Data were analyzed using SPSS version 26 software. Descriptive statistics were used to summarize the data. Univariate analysis was used to assess the association between potential risk factors and hepatitis. Multivariate analysis was used to control for potential confounders. Results: Elderly patients (>60 years) demonstrated a significantly higher risk of DILI (39.5%) compared to younger counterparts (<20 years, 10.3%). Extensive disease, co-morbid conditions, a history of previous TB, smokers, and low serum albumin levels emerged as significant risk factors. Conclusion: The study contributes valuable insights into the prevalence and risk factors associated with DILI during anti-tuberculosis therapy, facilitating improved risk prediction and patient management.