Incidence, Clinical Features and Impact on Anti-Tuberculosis Treatment of Anti-Tuberculosis Drug Induced Liver Injury (ATLI) in China

• DOI: 10.1371/journal.pone.0021836
• Publication Date: 2011-07-05T21:22:09Z
• Authors: Penghui Shang; Yinyin Xia; Feiying Liu; Xiaomeng Wang; Yanli Yuan; Daiyu Hu; Dehua Tu; Yixin Chen; Peiyuan Deng; Shiming Cheng; Lin Zhou; Yu Ma; Lizhen Zhu; Weiwei Gao; Hongyuan Wang; Dafang Chen; Li Yang; Pingping He; Shanshan Wu; Shaowen Tang; Xiaozhen Lv; Zheng Shu; Yuan Zhang; Zhirong Yang; Yan Chen; Na Li; Feng Sun; Xiaoting Li; Yingjian He; Paul Garner; Siyan Zhan
• Keywords: Anorexia; Cumulative incidence

Background Anti-tuberculosis drug induced liver injury (ATLI) is emerging as a significant threat to tuberculosis control in China, though limited data available about the burden of ATLI at population level. This study aimed estimate incidence ATLI, better understand its clinical features, and evaluate impact on anti-tuberculosis (TB) treatment China. Methodology/Principal Findings In population-based prospective study, we monitored 4,304 TB patients receiving directly observed strategy (DOTS) treatment, found that 106 developed with cumulative 2.55% (95% Confidence Interval [CI], 2.04%–3.06%). Nausea, vomiting anorexia were top three most frequently symptoms. There 35 (33.02%) no symptoms, including 8 severe hepatotoxicity. Regarding prognosis 84 cases (79.25%) recovered, 18 (16.98%) improved, 2 (1.89%) failed respond continued elevation serum alanine aminotransferase, died result ATLI. Of all cases, 74 (69.81%) changed their anti-TB 4 (3.77%) medication administration change, 21 (19.81%) drugs replacement, 54 (50.94%) therapy interruption, 12 (11.32%) who discontinued therapy. terms outcomes, 53 (51.46%) had cured time, 48 (46.60%) prolonged, (1.94%) died. Compared non-ATLI patients, 9.25-fold (95%CI, 5.69–15.05) risk unsuccessful outcomes 2.11-fold (95%CI,1.23–3.60) prolonged intensive phase. Conclusions/Significance could considerably treatment. Given size negative substantial. Therefore, more research efforts are warranted order enhance diagnosis prevention