Drug-related hepatitis in patients treated with standard anti-tuberculosis chemotherapy over a 30-year period
DESIGN: We prospectively examined the incidence of drug-induced hepatitis in 2070 patients treated for TB with the standard regimen based on 6 months of rifampicin (R, RMP) and isoniazid (H, INH), with 2 months of initial pyrazinamide (Z, PZA) and ethambutol (E, EMB), over a 30-year period from 1981 to 2010, in Blackburn, UK.
RESULTS: Of the 1031 (49.8%) males and 1039 (50.2%) females studied, 451 (21.8%) were White and 1585 (76.6%) were of South Asian origin. Only 34 (1.6%) were of African or other origins. Of the total number of patients treated, 63 (3.0%) had drug-related hepatitis, 26 (5.8%) of whom were White, 37 (2.33%) Asians and 0 other. Incidence was significantly higher in Whites than Asians (OR 2.13, P = 0.008). Incidence increased with increasing age (OR 1.16, P = 0.02). The presumed causative drug was PZA 57%, RMP 32%, INH 11%, EMB 0%. There was no trend of increased hepatitis rates over time.
CONCLUSION: Rates of drug-induced hepatitis where change of treatment is required are low in patients treated with standard RHZE-based therapy (3%). Caucasians and older patients were more likely to develop hepatitis than their counterparts.
Document Type: Research Article
Affiliations: 1: Department of Respiratory Medicine, University Hospital South Manchester, Manchester, UK; Institute of Inflammation and Repair, University of Manchester, Manchester, UK 2: Chest Clinic, Royal Blackburn Hospital, Haslingden Road, Blackburn, UK 3: Department of Medical Statistics, University Hospital of South Manchester, Manchester, UK 4: Institute of Inflammation and Repair, University of Manchester, Manchester, UK; Chest Clinic, Royal Blackburn Hospital, Haslingden Road, Blackburn, UK; Lancashire Postgraduate School of Medicine and Health, University of Central Lancashire, Preston, Lancashire, UK
Publication date: December 1, 2016
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