Anti-tuberculous therapy induced liver injury: Frequency, management and outcome

Habib Ullah Khan, Muhammad Hussain Khan, Abdul Mateen Khan, Noor Ul Iman, Humera Khan, Hafsa Habib

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objectives: Drug induced liver injury can occur during anti-tuberculous therapy. The purpose of this study was to determine its frequency, management and outcome. Material & Methods: This descriptive study was conducted from July 2007 to June 2008, at Medical Specialist Clinic, Rauf Medical Centre, D.I. Khan. Patients on anti-tuberculous therapy were studied. Those having anorexia, nausea/vomiting or jaundice and raised ALT were labeled as having drug induced liver injury. Hepatotoxic drugs, i.e. rifampicin, isoniazid and pyrazinamide were stopped and replaced by non-hepatotoxic medications and ALT monitored every 2 weeks. On normalization of ALT and resolution of symptoms, two hepatotoxic drugs i.e. rifampicin and INH were restarted. The duration from start of anti-tuberculous therapy to drug induced liver injury, resolution after stopping it and response on restarting was recorded. Results: Among 250 patients with tuberculosis, 25(10%) developed drug induced liver injury. Time interval between start of therapy and onset of symptoms was 6-120 days. ALT ranged from 80-435U/L. After stopping hepatotoxic drugs, ALT normalized in 2-10 weeks. Only one(4%) patient re-developed hepatitis, the rest 24(96%) patients did not show any rise in ALT or clinical symptoms of hepatitis after restarting hepatotoxic anti-TB drugs. Conclusion: Drug induced liver injury occurs in 10% patients on anti-tuberculous therapy. It mostly occurs in the first four months of therapy, resolves after stopping hepatotoxic drugs and most of the time does not recur by giving two of the hepatotoxic medications i.e. rifampicin and INH.

Original languageEnglish
Pages (from-to)99-102
Number of pages4
JournalJournal of Medical Sciences
Issue number2
StatePublished - Jul 2009


  • Drug induced hepatitis
  • Drug induced liver injury
  • Hepatotoxic drugs
  • Tuberculosis


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