Antituberculosis drug-related liver dysfunction in chronic hepatitis B infection

Liver toxicity is a common side effect of antituberculosis (anti-TB) drugs. We studied the differences in liver dysfunction observed during anti-TB tr eatment between hepatitis B virus carriers (HBV) and noncarriers. Three hun dred twenty-four patients on anti-TB drugs were recruited and followed up f or 1 year. Forty-three patients with HBV and 276 non-HBV patients were incl uded for analysis. Liver function tests and viral markers were monitored mo nthly. Liver biopsy was requested whenever the alanine transaminase (ALT) w as persistently abnormal. Eighty-six HBV carriers who were not given anti-T B drugs were chosen as a second control and evaluated prospectively. The in cidence of liver dysfunction was significantly higher in HBV carriers given anti-TB drugs (34.9%) when compared to noncarriers (9.4%, P<.001) and with HBV carriers not given anti-TB drugs (8.1%, P<.001), For patients given an ti-TB drugs, HBV carriers who developed liver dysfunction were younger (P = .011) and had more severe liver injury compared with noncarriers (P =.008), By multiple logistic regression analysis, age (P =.002) and hepatitis B in fection (P <.001) were the only 2 significant risk factors for hepatotoxici ty related to anti-TB therapy.