Hepatotoxic effects of therapies for tuberculosis

Nat Rev Gastroenterol Hepatol. 2010 Oct;7(10):543-56. doi: 10.1038/nrgastro.2010.134. Epub 2010 Aug 31.

Abstract

Hepatotoxic effects attributable to antituberculosis therapy are considered unique among drug-related liver problems because almost all first-line antituberculosis medications have such adverse effects, which vary in severity according to the drug and the regimen. In addition, all regimens for the treatment of active tuberculosis include a combination of medications that must typically be administered for at least 6 months to ensure complete cure of the disease and to minimize the development of drug-resistant bacterial strains. Hepatotoxic effects are a serious problem in patients who are undergoing treatment for tuberculosis, not only because of the morbidity and mortality they directly cause, but also because the liver symptoms can necessitate interruption of therapy or affect a patient's adherence to it, which can limit the efficacy of the antitubercular regimen.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Antitubercular Agents / adverse effects*
  • Antitubercular Agents / therapeutic use
  • Chemical and Drug Induced Liver Injury / epidemiology*
  • Chemical and Drug Induced Liver Injury / physiopathology
  • Chemical and Drug Induced Liver Injury / prevention & control
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Liver Function Tests
  • Male
  • Risk Factors
  • Tuberculosis / drug therapy*

Substances

  • Antitubercular Agents