LIVER FUNCTION TESTS IN PATIENTS OF PULMONARY TUBERCULOSIS USING FOUR DIFFERENT DRUG REGIMENS

Authors

  • M ZAMIR AHMAD AKBRI
  • NIGHAT FATIMA
  • EHSAN UL HAQUE
  • ABDUS SALAM SHEIKH
  • MUHAMMAD SARWAR BHATTI

Abstract

Background: Chemotherapy is the basic approach to clinical tuberculosis control. Antituberculous therapy causesderangement of hepatic functions revealed by disturbed liver function tests. The incidence of side effects may varydepending upon a number of factors. The primary purpose of this study was to determine the relative and absolutehepatotoxicity of different antituberculous drug regimens in Pakistani population where majority of the tuberculouspatients belong to poor socioeconomic status. Methods: One hundred patients between 30 to 70 years of age withnewly diagnosed pulmonary tuberculosis were selected and divided into four groups on the basis of different drugregimens. Blood and urine tests of these patients were made. Liver function tests were performed before therapy andthen after one. two. three, six and nine months of treatment. Results <& Conclusions: Antituberculous therapy causesderangement of hepatic function to a variable extent in patients of four different antituberculous drug regimens understudy. Drug combination of Streptomycin. Isoniazid and Myambutol seem to be best tolerated of all the four regimens.Monitoring of the liver function in patients on antituberculous therapy indicated that liver dysfunction most frequentlyoccurs during first three months of therapy. There is a tendency for enzyme values to return to normal inspite ofcontinuous treatment. The mechanism underlying this adaptation to injury to the liver is unknown. Biochemical testsin the patients presenting with jaundice yielded the pattern of acute hepatocellular necrosis with high transaminasesand moderately elevated Alkaline Phosphatase. None of the patients had hepatitis associated antigen in their serum.

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