MANIFESTATION OF 1ST LINE ATT INDUCED HEPATOTOXICITY: AN EVALUATION OF THE CLINICAL SPECTRUM, DETERMINING FACTORS AND ADVERSE DRUG REACTION ANALYSIS

Objectives: Antitubercular treatment (ATT)-induced liver injury has been one of the major causes of drug-induced liver injury (DILI). It is associated with multiple attributable risk factors. The study was planned to determine the various risk factors associated with ATT-induced liver injury and to perform causality analysis for suspected adverse drug reactions. The Methods: observational follow-up study was done in Himalayan Hospital, Dehradun from 2018 to 2019. Patients were taken on modied ATT and followup was done weekly with LFT. Later, 1st line ATT was re-challenged to evaluate for offending drug. A total of 180 patients developing Results: symptoms following 1st line ATT intake were evaluated. Loss of appetite, nausea and vomiting were the most common symptoms. Re challenging with rst-line ATT was tolerated by 85% of patients. Pyrazinamide was the most common offending ATT causing DILI. Advanced age, hypoalbuminaemia and underlying Liver disease had a signicant association with ATT-induced DILI. Upon causality analysis, 65.6% of patients were classied as probable according to the WHO-UMC scale. Elderly (≥60 ye Conclusion: ars), hypoalbuminaemia and underlying Liver disease were signicant risk factors for ATT-induced DILI. Pyrazinamide was the most common drug to cause ATT-induced DILI.