A STUDY OF DRUG-INDUCED LIVER INJURY AND LFT MONITORING IN PULMONARY TUBERCULOSIS PATIENTS REGISTERED WITH NTEP

Introduction- Tuberculosis (TB) remains a major health challenge in India, with the highest global burden. Anti-tuberculosis therapy (ATT) under NTEP has improved outcomes but is associated with Drug-Induced Liver Injury (DILI). First-line drugs like isoniazid, rifampicin, and pyrazinamide can cause hepatotoxicity, especially in high-risk groups. DILI may lead to treatment interruption, non-adherence, and drug resistance. Regular monitoring of Liver Function Tests (LFTs) aids in early detection and management of hepatotoxicity. This study evaluates the incidence of DILI and the role of LFT monitoring in pulmonary TB patients on ATT. Objective: To evaluate liver function test (LFT) values in pulmonary tuberculosis patients undergoing anti-tubercular therapy (ATT) and assess their correlation with hepatotoxicity. Materials And Methods - In our study 100 patient with pulmonary TB ,who met the inclusion and exclusion criteria were selected from the medicine wards and OPD at department of internal medicine. LFT was measured at baseline and a week after initiating rst line ATTas per NTEP. Results - Among 100 pulmonary tuberculosis patients initiated on anti-tuberculosis therapy (ATT).After one week of ATT 15 (15%) developed Drug-Induced Liver Injury (DILI) as per WHO criteria. The injury patterns included mixed (40%), hepatocellular (33.3%), and cholestatic (26.7%). Severity grading revealed that 11 patients (73.3%) had Grade 3 (severe) DILI, while 2 patients each (13.3%) had Grade 1 (mild) and Grade 2 (moderate) DILI. No cases progressed to Grade 4 (life-threatening) or acute liver failure. Early monitoring and timely intervention likely prevented severe clinical outcomes. Conclusion– DILI is a common occurrence during the course of anti-TB treatment. Monitoring of LFTs can detect the liver injury and helps in the management and serious prevention of ATLI. Most patients show tolerance to anti-TB drugs and get adjusted after transient rise in liver enzymes.