The Effect of Anti-tuberculosis Drugs on Liver Enzymes in Iraqi Patients

Abstract

Ali Adnan Jabbar, Sarah Ali Abed, Enas Yassen Jasim, Thoalfiqar khudhair Shamkhi.

Tuberculosis is a national and world-wide spreading disease that many patients suffer from in addition to their battle with the disease itself, a new health challenging aspect is added which is the adverse effects of the anti-tuberculous drugs, as they have a hepatotoxic effect therefore this study has targeted the effect of anti-tuberculous drugs on liver enzymes. The study was conducted in three cities in Iraq (Baghdad, Samawah and diyala) 30 patients in total. All patients were registered in the national centers of infectious diseases according to their city. patients were monitored for four months for liver enzymes level (ALT, AST and ALP) , which were markedly elevated in the first two months then a promising recovery to normal levels in the later four months. Combined therapy of pyrazinamide, rifampicin, ethambutol and isoniazid has been used to all patients equally.
Patient and Methods : In descriptive study, a total of 30 cases aged from 7-65 years where collected from the national centers of tuberculosis centers in Iraq, from july 2018 to January 2019.pateints were treated for two months with combined drug formula (rifampicin, ethambutol, isoniazid and pyrazinamide) followed by isoniazid and rifampicin for the second two months. Blood samples were collected at 7 occasions, before treatment followed by 1 months, 2 months, 3 months, 4 months, 5 months and 6 months. Investigated for ALT, AST and ALP. Data were analyzed using SPSS ver. 23, results expressed as means and ± standard deviation, paired sample t -test study was used.
Inclusion and Exclusion: Patients included in our study were with pulmonary tuberculosis or extra pulmonary tuberculosis, planned and completed a full course of antituberculous. Any patient didn’t complete the course and followed the treatment protocol was excluded.
Statistical analysis: Data is presented as means ± standard deviation (S.D) and were compared using paired sample t-test for continuous variables and Wilcoxon test. SPSS version 23.0 was used for analyzing the data, and p-values ≤ 0.05 were considered significant