आईएसएसएन: 2311-3278
Sarvesh Singh
Introduction
According to the Global Tuberculosis’s Report 2017, the incidence of tuberculosis (TB) in India was approximately 28,00,000 that is one-fourth of the world’s TB cases . The Government of India was started the Revised National Tuberculosis Control Programme (RNTCP) in the year 1992, headed by expert committee, for the entire country, in phased manner. This program helps to face the disease in a more managed and classified form by incorporating a new drug regimen – The Directly Observed Treatment Short Course (DON’T). DOTS make’s the available to free and compulsory good-quality ant tubercular drugs under direct supervision and making the program more effective. According to the Union Ministry of Health and Family Welfare, 2.6 lakh TB cases were reported in Uttar Pradesh in 2016.
A combination of five ant tuberculosis drugs - isoniazid, rifampicin, ethambutol, pyrazinamide, and streptomycin - was recommended for first-line treatment. But the success rate of these treatments were depends upon the pharmacokinetics of individual’s. Hepatotoxicity is a serious adverse effect due to the use of ant tuberculosis drugs in great TB burden countries. The occurrence of ATD-induced the hepatotoxicity affects’ to management of TB, and leading to delay’s or the failure of the treatment.
Materials And Methods:
In this prospective study, patients of age will more than 18 years were recruited from the outpatient department or the inpatient facility of the departments of pharmacology and Therapeutics, Clinical haematology, and Respiratory medicine, Gandhi Memorial and Associated Hospitals, King George’s Medical University, Lucknow, Uttar Pradesh, India, between November 2017 to September 2018 after obtaining the ethical clearance from the institute’s ethical committee.
A total no of 100 TB positive patients were recruited in this study. Further, the TB patients were divided into two groups on the basis of anti-TB drugs (ATDs)-induced toxicity. After the treatment with ATDs, 30 pulmonary TB patients developed to the clinical or laboratory-confirmed DIH, whereas 70 patients’ with pulmonary TB did not develop DIH and constituted the controls. Informed written consent was obtained from all the TB patients. Clinical data, such as the disease stage, liver function test, treatment details, and the history of comorbid conditions, were extracted from the patients’ charts.
Results:
The demographic profiles of the TB patients of ATDIH group and the tolerant control group were shown in the Table 1. There was a significant increase in AST and ALT in the ATDIH wasas compared to the tolerant control group after one month of treatment.