ASSESSMENT OF DRUG INDUCED HEPATOTOXICITY IN PATIENTS TREATED FOR TB/HIV CO-INFECTIONS IN AYDER REFERRAL HOSPITAL ART CLINIC, MEKELLE; ETHIOPIA
Minyahil A. Woldu*, Addishiwot G. Zewde and Jimma L. Lenjissa
ABSTRACT
Background: Concomitant use of treatment for tuberculosis and
antiretroviral therapy is complicated by the adherence challenge of
polypharmacy and overlapping side effect like drug-induced
hepatotoxicity. Objective: To determine the prevalence of
hepatotoxicity in patients treated for the co-infections of TB/HIV using
serum ALT levels as marker of hepatotoxicity. Result: The most
frequent type of hepatotoxicity grade observed was toxicity degree
type one, which was observed in 45% of the patients. Five percent of
female and 10% male on HAART and anti-TB medications developed hepatotoxicity.
Patient in age between 19-62 year were develop almost double the prevalence i.e 10%,
compared to 4% in /=63 year. The prevalence of severe
hepatotoxicity (grade 2 or more) was 15 (15%). There was no significant correlation in
toxicity grade at baseline ALT measures, (Spearman Correlation Asymp. Sig. (2-sided) =
.878). However, the ALT measure after three month showed that significant association with
the grades of toxicity, (Spearman Correlation Asymp. Sig. (2-sided) = .000). HCV infection
was significantly associated with the risk of hepatotoxicity, which occurred in 3 out of 4 of
the study participants (OR, 22.7; P.value, 0.34). Conclusion: The prevalence of
hepatotoxcity in the study area was comparable to other similar studies. HBV co-infection was an independent risk factor for hepatotoxicity. Clinicians must consider the possibility of
drug-induced liver injury in the management of HIV-infected patients, especially in those
with certain risk factors such as co-infection with hepatitis B virus (HBV).
Keywords: Drug induced hepatic injury, TB/HIV co-infections, Heptotoxicity.
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