%0 Journal Article
%T Anti-Tuberculosis Drug Induced Hepatotoxicity among TB/HIV Co-Infected Patients at Jimma University Hospital, Ethiopia: Nested Case-Control Study
%A Alima Hassen Ali
%A Tefera Belachew
%A Alemeshet Yami
%A Wubeante Yenet Ayen
%J PLOS ONE
%D 2013
%I Public Library of Science (PLoS)
%R 10.1371/journal.pone.0064622
%X Background This study was carried out to determine the incidence and predictors of anti-tuberculosis drug induced hepatotoxicity among TB/HIV co-infected patients at Jimma University Hospital, Ethiopia. Methods/Principal Findings A nested case-control study was conducted by reviewing charts of all TB/HIV co-infected patients who commenced anti-TB treatment from January 2008 to December 2011 at Jimma University Hospital. Patients who had developed hepatotoxicity after at least 5 days of standard doses of anti-TB drug therapy were labeled as ※cases§ and those without hepatotoxicity were ※controls§. Each case with anti-TB drug induced hepatotoxicity was compared with 3 controls selected randomly from the cohort. From a cohort of 296 TB/HIV co-infected patients 8 were excluded from the study as the causality between anti-TB drugs and hepatotoxicity was not confirmed, 33 had developed hepatotoxicity. On bivariate logistic regression analysis, body mass index (BMI) <18.5 Kg/m2 [P = 0.01; OR (95%CI): 3.6 (1.4每9.5)], disseminated pulmonary TB [P = 0.00; OR (95%CI): 5.6 (2.2每14.6)], CD4 count ≒50 [P = 0.016; OR (95%CI): 3.6(1.27每10.23)] and WHO stage 4 [P = 0.004, OR (95%CI): 3.8 (1.68每8.77)] were significantly associated with anti-TB drug induced hepatotoxicity. Predictor variables with p-value <0.05 by bivariate analysis were analyzed using multivariable logistic regression analysis and identified disseminated pulmonary TB [P = 0.001; AOR (95%CI) = 5.6 (2.1每15.0)] and BMI <18.5 [P = 0.014; AOR (95%CI) = 3.6 (1.3每10.1)] as independent predictors of anti-TB drug induced hepatotoxicity. Conclusions The incidence of anti-TB drug induced hepatotoxicity was 11.5%. The results suggest that in the presence of disseminated pulmonary TB and/or BMI <18.5 Kg/m2, TB/HIV co-infected patients should be closely followed for the occurrence of hepatotoxicity during the intensive phase of TB treatment to prevent morbidity and mortality.
%U http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0064622