RISK ASSESSMENT AND MONITORING OF HEPATOTOXIC REACTIONS IN TUBERCULOSIS PATIENTS

Abstract

In order to detect risk groups for drug-induced liver lesions and to develop the procedure for differential monitoring of liver tests during tuberculosis chemotherapy, a prospective study was performed including 435 new tuberculosis patients. The one-dimensional and regression analysis helped to identify risk factors of drug-induced liver lesions (female sex, poor nutrition, absentation from smoking, history of medicamentous allergy), and based on them scores for risk assessment before the start of chemotherapy were worked out and validated. Drug-induced liver lesions developed in 110 patients (25.3%, 95% CI 21.4-29.6), of them 45 (40.9%) developed liver lesion during first 14 days after the start of chemotherapy. The group facing a higher risk of drug-induced liver lesions developed them after a longer period of time; the number of early liver lesions made 18.5% in the high-risk group, and 6.6% (p = 0.02) in the low-risk group. The procedure of laboratory monitoring depending on the degree of risk was offered for early diagnostics of drug-induced liver lesions.

Keywords

• противотуберкулезная химиотерапия
• лекарственное поражение печени
• факторы риска
• мониторинг