Hepatotoxicity Due to Antituberculosis Therapy among Paediatric Patients Seen at the University of Ilorin Teaching Hospital, North Central Nigeria

Abstract

BACKGROUND: The liver is vulnerable to injury from the firstline anti-tuberculosis drugs. This may result in mortality, long termmorbidity and reduced compliance to therapy. Nigeria recentlyintroduced fixed drug combinations in the treatment of childrenamid concerns of hepatotoxicity. A 6-year-old boy was treated inour unit had fulminant hepatic failure two weeks after completinghis anti-tuberculosis therapy. This prompted the unit to investigatehepatotoxicity due to anti-tuberculosis therapy among children.There is no data on the incidence of hepatotoxicity due toantituberculosis therapy among Nigerian children, and no uniformguide to monitoring of patients exists. The objective of this studywas to investigate the incidence of hepatotoxicity among childrenreceiving anti-tuberculosis therapy.METHODS: A cross-sectional study was conducted among all 62cases that completed treatment over a two year period. LiverFunction Tests was done at baseline and 2 and 5 months oftherapy. Elevation of Alanine aminotransferase and/or Aspartateaminotransferase above 3 times the reference values wasconsidered an indication of hepatotoxicity.RESULTS: A total of 62 patients aged 3 months -17 years weretreated at our unit during the study period. Twenty-two (35.5%)had elevated liver enzymes at baseline. Four (6.5%) had elevationof alanine aminotransferase of 3 times the upper limit at 2 months,but at 5 months, tests were within normal limits in all patients.Hepatotoxicity defined as liver enzymes above 3 times upper limitwas not documented among the 62 cases treated over the period.CONCLUSION: Hepatotoxicity due to antituberculosis therapy isuncommon in children, hence repeated routine evaluation of liverfunction may not be necessary in all patients receiving anti-TBtherapy.