Investigation of hepatotoxicity of antituberculosis medications in some hospitals, Khartoum State

Background: Tuberculosis (TB) is an ancient disease still kills more than two million people every year, despite the fact that a cure has been available for over 50 years. Some antituberculosis agents cause hepatotoxicity as a major adverse drug reaction. Objectives: This study was designed to investigate rifampicin, isoniazid and pyrazinamide induced-hepatotoxicity among TB patients in Sudan. Methods: Sudanese in-patients (n=57) their ages ranged between 15 to 76 years, with active pulmonary tuberculosis and normal pretreatment liver function, received rifampicin (10 mg/Kg/day), isoniazid (5 mg/Kg/day) and pyrazinamide (20 mg/Kg/day) daily for two months, were involved in this study. Liver function test was performed for each patient separately at week 8, 9 and 10, to assess direct and indirect bilirubin, alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, albumin and total protein levels. Results: Liver function tests revealed that 10 (17.5%) patients had high serum total bilirubin level, whereas 46 (80.7%) of them showed significant alteration in direct (conjugated) bilirubin level. Five (8.7%) and 23 (40.3%) patients demonstrated increased serum level of alanine aminotransferase and alkaline phosphatase respectively. Moreover, 15 (26.3%) of the treated patients experienced higher serum levels of aspartate aminotransferase. Hepatotoxicity and symptoms of liver failure occurred in 9 (15.7%) patients, which necessitate treatment discontinuation. Thirty eight (66.6 %) of the treated patients developed alteration in serum albumin level, whereas slight alteration in total protein level was found in 12 (21%) of the TB patients. Conclusions: Biochemical investigations and clinical monitoring of patients treated with antituberculosis drugs are essential to decrease hepatotoxicity of these agents. الخلفية : السل مرض قديم لا يزال يقتل أكثر من مليوني شخص كل عام٬ على الرغم من أن علاجه متوافرا لأكثر من 50 عاما. بعض الأدوية المضادة للسل تسبب التسمم الكبدي كردة فعل عكسي نتيجة لاستخدام الدواء. الأهداف : صممت هذه الدراسة لفحص٬ التسمم الكبدي الناتج من الريفامبيسين الإيزونيازيد و البيرازيناميد بين مرضى السل-في السودان. الطرق : شارك في هذه الدراسة مرضى سودانيين (عددهم = 57) تراوحت أعمارهم ما بين 15 إلى 76 سنة٬ مصابين بسل رئوي نشط و كانت نتيجة فحص وظائف الكبد طبيعية قبل المعالجة٬ تلقوا الريفامبيسين (10 ملغ / كغ / يوم)٬ أيزونيازيد (5 ملغ / كغ / يوم) و بيرازيناميد (20 ملغ / كغ / يوم) يوميا لمدة شهرين، تم إجراء فحص وظائف الكبد لكل مريض على حدة في الأسبو