https://scholars.lib.ntu.edu.tw/handle/123456789/512472
標題: | Hepatotoxicity due to first-line anti-tuberculosis drugs: A five-year experience in a Taiwan medical centre | 作者: | CHIN-CHUNG SHU Lee C.-H. Lee M.-C. JANN-YUAN WANG CHONG-JEN YU LI-NA LEE |
公開日期: | 2013 | 卷: | 17 | 期: | 7 | 起(迄)頁: | 934-939 | 來源出版物: | International Journal of Tuberculosis and Lung Disease | 摘要: | BACKGROUND: Hepatotoxicity with first-line drugs, a major complication of anti-tuberculosis treatment, has not been studied by time-dependent analysis. DESIGN: Adult patients diagnosed with pulmonary tuberculosis (PTB) from 2005 to 2009 were reviewed retrospectively. Hepatotoxicity during anti-tuberculosis treatment was defined by symptomatic elevation of liver transaminases ?3 times the upper limit of normal, or ?5 times if asymptomatic. Risk factors for hepatotoxicity were investigated using time-dependent Cox regression analysis. RESULTS: Of 926 patients identified and followed for 4122.9 person-months (pm), 111 (12.0%) developed hepatotoxicity after a median 38.0 days from start of treatment. Around 3.5% had severe hepatotoxicity. The most common symptoms were general malaise and poor appetite. The incidence rate of hepatotoxicity was 0.59, 0.69 and 3.71/100 pm for isoniazid, rifampicin (RMP) and pyrazinamide (PZA), respectively. Old age, female sex, autoimmune disease, human immunodeficiency virus infection, more days with PZA in the last 8-14 days, and fewer days with RMP in the last 15-21 days before hepatotoxicity were independent risk factors for hepatotoxicity during treatment. CONCLUSION: A significant number of adult patients on first-line treatment experience hepatotoxicity. PZA is the most common causative drug. For high-risk patients, careful adjustment of the anti-tuberculosis regimen and regular monitoring of liver transaminases are necessary. ? 2013 The Union. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84878938023&doi=10.5588%2fijtld.12.0782&partnerID=40&md5=eefe0553b019d2011b582a93122bf8d8 https://scholars.lib.ntu.edu.tw/handle/123456789/512472 |
ISSN: | 1027-3719 | DOI: | 10.5588/ijtld.12.0782 | SDG/關鍵字: | alanine aminotransferase; aspartate aminotransferase; bilirubin; ethambutol; isoniazid; liver enzyme; pyrazinamide; quinoline derived antiinfective agent; rifabutin; rifampicin; tuberculostatic agent; abdominal pain; acute kidney failure; adult; age; aged; alanine aminotransferase blood level; anorexia; article; aspartate aminotransferase blood level; autoimmune disease; bilirubin blood level; controlled study; disease severity; drug induced disease; drug substitution; drug withdrawal; female; fever; follow up; gender; human; Human immunodeficiency virus infection; hyperbilirubinemia; incidence; liver toxicity; lung tuberculosis; major clinical study; malaise; male; nausea; patient monitoring; priority journal; pruritus; rash; retrospective study; risk factor; side effect; Taiwan; thrombocytopenia; treatment duration; vomiting; Adult; Aged; Aged, 80 and over; Antitubercular Agents; Drug-Induced Liver Injury; Female; Follow-Up Studies; Humans; Incidence; Male; Middle Aged; Proportional Hazards Models; Regression Analysis; Retrospective Studies; Risk Factors; Severity of Illness Index; Taiwan; Time Factors; Transaminases; Tuberculosis, Pulmonary |
顯示於: | 醫學系 |
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