Resumen de Hepatotoxicidad por fármacos antituberculosos

E. Sánchez Yáñez, María del Rosario Mora Santiago, José Manuel Fernández Oviés

• Objective: To analyze the incidence and type of hepatic damage caused by antituberculosis treatment. Indirectly, we want to analyze hepatotoxicity's economic consequences for the Healthcare System. Method: Observational prospective study on patients with anti-tuberculosis treatment at the University Clinical Hospital Virgen de la Victoria from Malaga, (November 2008-October 2009). Results: We analyzed data from 74 patients. The global incidence of hepatic damage (HD) was 14.9%. The incidence of HD was higher in women, in black patients and in compulsive drinkers, without finding any significant statistical differences. For age and Body Mass Index (BMI), there were no differences either given the population's homogeneity. The HD incidence was significantly higher (p < 0.05) in patients with more severe forms of tuberculosis (TBC) and HIV patients. The received doses, weight adjusted, were similar in patients with favorable evolution (FE) as in patients with HD. Patients with HD received more days of treatment than those with FE. 72.7% of patients had cholestatic/mixed damage, and in 27.3% hepatocellular damage. The average admission duration was 14 days (SD = 9) for the group with FE and 25 days (SD = 15) for the group with HD. Hepatotoxicity was the first cause of re-admission. Conclusions: Factors like HIV infection or the severity of TBC may influence by increasing the incidence of TBC. Data for other factors like the female gender, black race or alcohol consumption, although they lead to an increase in HD, are not conclusive. Hepatocellular damage was less frequent, but more severe. The development of HD increases the healthcare costs by prolonging the therapy and hospital admission, and it is cause for re-admission