The Risk of Hepatotoxicity Associated with HAART/Anti-Tb Co-Treatment: A Case Control Study in a Central Ethiopian Referral Hospital
|Minyahil Alebachew Woldu1*#, Henok Demeke Getaneh2#, Jimma Likisa Lenjisa2, Gobezie Temesgen Tegegn2, Gurmu Tesafye Umeta2 and Hunduma Dinsa Ayano2|
|1Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia|
|2Clinical Pharmacy unit, Department of Pharmacy, Ambo University, Ambo, Ethiopia|
|#These authors have contributed equally to the paper|
|Corresponding Author :||Minyahil Alebachew Woldu
Addis Ababa University, School of Pharmacy
Department of Pharmacology and Clinical Pharmacy
P.O. Box: 9086, Addis Ababa, Ethiopia
E-mail: [email protected]
|Received July 24, 2014; Accepted August 23, 2014; Published August 25, 2014|
|Citation: Woldu MA, Getaneh HD, Lenjisa JL, Tegegn GT, Umeta GT, et al. (2014) The Risk of Hepatotoxicity Associated with HAART/Anti-Tb Co-Treatment: A Case Control Study in a Central Ethiopian Referral Hospital. Fam Med Med Sci Res 3:129. doi:10.4172/2327-4972.1000129|
|Copyright: © 2014 Woldu MA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Background: Hepatotoxicity is historically the 3rd most common reason for ART toxicity related discontinuation. Liver toxicity leads to medical visit, work plan exams, and frequent hospital admissions all of which increases expenses. The objective of this study was to determine the risk of hepatotoxicity and identify the major predictors that may cause hepatotoxicity in the study place.
Methods: A case-control study was done by reviewing a total of 105 TB/HIV co- infected patients' charts. Results: Of the total 105 patients included in the study, 21 (20%) developed hepatotoxicity. Fifty four (51.43%) of the participants were females. The mean CD4 count of the patients was 205.1 + 96.18 cells/μL and ranged from the lowest count of 51cells/μl to the highest recorded count of 559cells/μl. The most frequent anti-TB regimen prescribed was 2(INH, RIF, ETM, PZA)/4(INH, RIF). Ninety five (90.5%) of the participants were on the primarily prophylactic drugs. Of this figure, 49 (46.7%) were on cotrimoxazole. Number of female patients developed hepatotoxicity were 12 (57.1%). Most of the patients who had developed hepatotoxicity were in stage 3 of HIV/AIDS progression. Social drug use was significantly associated with development of hepatotoxicity (P=.005) with a 95% CI (0.01-311). Patients on TDF/3TC/EFV (OR= 121.7, P=.010) and D4T/3TC/NVP (OR= 47.4, P=.009) ART regimen were found to be more likely to develop hepatotoxicity compared to patients on D4T/3TC/EFV regimen. Similarly patients on 2(ERHZ)/4(RH) anti-TB regimen (OR= 575.96, P=.002) with a 95% CI (0.02-3.8), was found to be more likely to develop hepatotoxicity compared to the other types anti-Tb regimens.
Conclusions: The risk of hepatotoxicity in TB/HIV coinfected patients can be due to a number of factors among which sex, the WHO clinical staging, use of Social drugs, type of ART regimen and type of anti-TB regimen are the major, according to the findings of this study.