Drug-induced liver injury from antituberculous treatment: a retrospective study from a large TB centre in the UK.
Drug-induced liver injury from antituberculous treatment: a retrospective study from a large TB centre in the UK.
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DOI：
10.1186/s12879-017-2330-z
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发表时间：
2017-03-24
影响因子：
3.7
通讯作者：
John L
中科院分区：
文献类型：
--
作者：
Abbara A;Chitty S;Roe JK;Ghani R;Collin SM;Ritchie A;Kon OM;Dzvova J;Davidson H;Edwards TE;Hateley C;Routledge M;Buckley J;Davidson RN;John L
我们描述了伦敦一家大型结核病(TB)中心的抗结核治疗(ATT)后继发的药物性肝损伤(DILI)；我们确定了有DILI危险因素的人的比例以及DILI的时间和结局。我们确定了在治疗活动性肺结核期间出现DILI的连续患者；选择没有DILI的活动性结核病患者作为对照。记录全面的人口学和临床数据、管理和结果。在2010年4月至2014年5月期间确诊的1529例活动性结核病患者中，有105例(6.9%)与ATT相关的DILI。DILI的危险因素有：低患者体重、HIV-1混合感染、较高的基线碱性磷酸酶和饮酒。只有25.7%的患者有英国或美国胸科学会定义的肝脏检测(LT)监测标准。一半(53%)的病例发生在ATT开始后2周内，87.6%发生在8周内。7例死亡中有5例(4.8%)可归因于帝力。在发生DILI的患者中，只有四分之一的患者有英国或美国胸科学会为预防性LT监测制定的标准，这表明应该考虑对所有服用ATT的患者进行普遍的肝脏监测，特别是在治疗的前8周。本文的在线版本(doi：10.1186/s12879-017-2330-z)包含补充材料，授权用户可以使用。
We describe drug-induced liver injury (DILI) secondary to antituberculous treatment (ATT) in a large tuberculosis (TB) centre in London; we identify the proportion who had risk factors for DILI and the timing and outcome of DILI. We identified consecutive patients who developed DILI whilst on treatment for active TB; patients with active TB without DILI were selected as controls. Comprehensive demographic and clinical data, management and outcome were recorded. There were 105 (6.9%) cases of ATT-associated DILI amongst 1529 patients diagnosed with active TB between April 2010 and May 2014. Risk factors for DILI were: low patient weight, HIV-1 co-infection, higher baseline ALP, and alcohol intake. Only 25.7% of patients had British or American Thoracic Society defined criteria for liver test (LT) monitoring. Half (53%) of the cases occurred within 2 weeks of starting ATT and 87.6% occurred within 8 weeks. Five (4.8%) of seven deaths were attributable to DILI. Only a quarter of patients who developed DILI had British or American Thoracic Society defined criteria for pre-emptive LT monitoring, suggesting that all patients on ATT should be considered for universal liver monitoring particularly during the first 8 weeks of treatment. The online version of this article (doi:10.1186/s12879-017-2330-z) contains supplementary material, which is available to authorized users.