Anti-tuberculosis drug-induced hepatotoxicity among patients undergoing tuberculosis treatment at the Antituberculosis Center of Brazzaville, Republic of Congo.

OBJECTIVES: Liver function abnormalities during tuberculosis (TB) treatment can indicate anti-TB drug-induced liver injury (ATLI), a serious adverse event. Therefore, this study aims to evaluate transaminase levels in a cohort of patients with TB undergoing treatment. It also assesses the prevalence and severity of ATLI.

METHODS: We conducted a cross-sectional study of 235 patients with TB during the intensive phase (2 months) of treatment to assess liver function. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured, and hepatotoxicity was graded according to the World Health Organization/common terminology criteria for adverse events criteria. HIV was screened according to the national algorithm, and hepatitis B was assessed serologically.

RESULTS: Median ALT and AST levels varied by age, sex, and HIV status. Males had higher ALT (19.2 vs 15.3 IU/l;= 0.009) and AST (28.1 vs 24.0 IU/l;= 0.009) levels than females. Levels increased with age (<0.05) and were higher in patients positive for HIV (ALT 25 vs 17.7 IU/l, AST 33 vs 27 IU/l;<0.05). No differences were observed according to hepatitis B status. Overall, 53 (22.6%) patients had elevated transaminases, mostly mild (92.5%), whereas 7.5% experienced ATLI.

CONCLUSION: Hepatotoxicity was common at 2 months of TB treatment and was associated with male sex, older age, and HIV co-infection. These findings highlight the importance of regular liver function monitoring in these patient groups during treatment.