Clinical characteristics, serum albumin and eosinophil levels as risk factors for drug induced hepatitis in tuberculosis patients receiving fixed-dose combination anti-tuberculosis drug

Authors

  • Andriani Sheila Anastasia Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • I Ketut Agus Somia Department of Internal Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Ni Luh Putu Eka Arisanti Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Ni Wayan Candrawati Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Ida Ayu Jasminarti Dwi Kusumawardani Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • I Gusti Ngurah Bagus Artana Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Ida Bagus Ngurah Rai Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.18203/2349-3933.ijam20220776

Keywords:

DIH, TB, Anti-TB drugs

Abstract

Background: Drug-induced hepatitis (DIH) is a side effect of the usage of anti-tuberculosis (TB) drugs, which can cause alteration in treatment regiments and prolonged treatment. This study aim is to identify the risk factors that can be used to predict the occurrence of DIH on tuberculosis (TB) patients.

Methods: This was a case-control study, conducted at Sanglah central general hospital in Denpasar from January to June 2021. Data collection was carried out through the medical records of inpatients and outpatients who received fixed-dose combination anti-TB drug.

Results: There were 62 research samples which were divided into 31 samples in the case group and 31 samples in the control group. The clinical manifestations of DIH were vomiting (32.8%), nausea (15.7%), abdominal pain (13.1%), and hepatic encephalopathy (1.3%). Median time to onset of DIH was 18 (Interquartile range: 19) days. Low BMI was a significant risk factor for DIH (AOR=22.4; 95% CI 4.147-121.575; p<0.001). Other clinical characteristic variables such as age, female, extrapulmonary TB, positive HIV status, diabetes mellitus, hypoalbuminemia, and eosinophilia were not proven risk factors for DIH-TB.

Conclusions: Low BMI was a significant risk factor for DIH. Other variables such as age, female, extrapulmonary TB, positive HIV status, diabetes mellitus, hypoalbuminemia, and eosinophilia were not risk factors for DIH in TB patients.

Author Biographies

Andriani Sheila Anastasia, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

I Ketut Agus Somia, Department of Internal Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Internal Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Ni Luh Putu Eka Arisanti, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Ni Wayan Candrawati, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Ida Ayu Jasminarti Dwi Kusumawardani, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

I Gusti Ngurah Bagus Artana, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Ida Bagus Ngurah Rai, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

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Published

2022-03-24

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Original Research Articles