Antituberculosis drug-induced hepatotoxicity: concise up-to-date review.
Alma Tostmann,Martin J. Boeree,Rob E. Aarnoutse,Wiel C M de Lange,André J. A. M. van der Ven,Richard Dekhuijzen +5 more
TLDR
The incidence, pathology and clinical features of antituberculosis drug‐induced hepatotoxicity, the metabolism and mechanisms of toxicity of isoniazid, rifampicin and pyrazinamide, and risk factors and management are reviewed.Abstract:
The cornerstone of tuberculosis management is a 6-month course of isoniazid, rifampicin, pyrazinamide and ethambutol. Compliance is crucial for curing tuberculosis. Adverse effects often negatively affect the compliance, because they frequently require a change of treatment, which may have negative consequences for treatment outcome. In this paper we review the incidence, pathology and clinical features of antituberculosis drug-induced hepatotoxicity, discuss the metabolism and mechanisms of toxicity of isoniazid, rifampicin and pyrazinamide, and describe risk factors and management of antituberculosis drug-induced hepatotoxicity. The reported incidence of antituberculosis drug-induced hepatotoxicity, the most serious and potentially fatal adverse reaction, varies between 2% and 28%. Risk factors are advanced age, female sex, slow acetylator status, malnutrition, HIV and pre-existent liver disease. Still, it is difficult to predict what patient will develop hepatotoxicity during tuberculosis treatment. The exact mechanism of antituberculosis drug-induced hepatotoxicity is unknown, but toxic metabolites are suggested to play a crucial role in the development, at least in the case of isoniazid. Priorities for future studies include basic studies to elucidate the mechanism of antituberculosis drug-induced hepatotoxicity, genetic risk factor studies and the development of shorter and safer tuberculosis drug regimens.read more
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Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.
Payam Nahid,Susan E. Dorman,Narges Alipanah,Pennan M. Barry,Jan Brozek,Adithya Cattamanchi,Lelia H. Chaisson,Richard E. Chaisson,Charles L. Daley,M. Grzemska,Julie Higashi,Christine S Ho,Philip C. Hopewell,Salmaan Keshavjee,Christian Lienhardt,Richard Menzies,Cynthia Merrifield,Masahiro Narita,Rick O'Brien,Charles A. Peloquin,Ann Raftery,Jussi J. Saukkonen,H. Simon Schaaf,Giovanni Sotgiu,Jeffrey R. Starke,Giovanni Battista Migliori,Andrew Vernon +26 more
TL;DR: This guideline provides recommendations on the clinical and public health management of tuberculosis in children and adults in settings in which mycobacterial cultures, molecular and phenotypic drug susceptibility tests, and radiographic studies, among other diagnostic tools, are available on a routine basis.
Book ChapterDOI
Drug-induced liver injury.
Michael P. Holt,Changqing Ju +1 more
TL;DR: It is hoped that this chapter will shed light on the major problems associated with DILI in regards to the pharmaceutical industry, drug regulatory agencies, physicians and pharmacists, and patients.
Journal ArticleDOI
EASL Clinical Practice Guidelines: Drug-induced liver injury
Raúl J. Andrade,Guruprasad P. Aithal,Einar Björnsson,Neil Kaplowitz,Gerd A. Kullak-Ublick,Dominique Larrey,Tom H. Karlsen +6 more
TL;DR: These Clinical Practice Guidelines summarize the available evidence on risk factors, diagnosis, management and risk minimization strategies for drug-induced liver jury.
Reference EntryDOI
Biotransformation of Xenobiotics
TL;DR: The metabolic fate of a xenobiotic can have an important bearing on its toxic potential, the disposition of the compound in the body and the excretion of the compounds.
Journal ArticleDOI
British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children.
TL;DR: A practical but evidence-based approach to the diagnosis and treatment of central nervous system tuberculosis in children and adults is described and guidance on tuberculous meningitis (TBM), intra-cerebral tuberculoma withoutMeningitis, and tuberculosis affecting the spinal cord is presented.
References
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American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis.
Henry M. Blumberg,William J. Burman,Richard E. Chaisson,Charles L. Daley,Sue C. Etkind,Lloyd N. Friedman,Paula Fujiwara,M. Grzemska,Philip C. Hopewell,Michael D. Iseman,Robert M. Jasmer,Venkatarama Koppaka,Richard Menzies,Richard J. O'Brien,Randall Reves,Lee B. Reichman,Patricia M Simone,Jeffrey R. Starke,Andrew Vernon +18 more
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