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THE EFFECT OF ANTI TUBERCULOSIS DRUGS ON LIVER ENZYMES MOSUL IRAQ 2019-2020
Dr. Muyser Y. Alnaser*, Dr. Faris A. Mohammad
Background: Tuberculosis (TB) is a major cause of illness and death worldwide especially in Asia and Africa Anti tuberculosis drugs cause hepatotoxicity in some individuals leading to acute liver failure, which results in death. Such phenomena limit the clinical use of drugs, contributing to treatment failure that possibly causes drug resistance. Furthermore, associated risk factors for the development of anti- tuberculosis drug induced hepatotoxicity (anti-TB-DIH) so we need liver function test. Aim: Assess the percentage of liver dysfunction .change in liver enzymes in patients with active Mycobacterium Tuberculosis before and during treatment, and the implications of this for treatment completion in Mosul Governorate from (?/??/???? -?/?/????). Methodology: A total of ?? consecutive TB patients were prospectively followed up both clinically and biochemically before and during their course of anti-TB therapy with daily doses of rifampin, isoniazid. ethambutol, pyrazinamide, and streptomycin, Total serum Bilirubin (T.S.B). Serum Alanine Transaminase(ALT), Serum Aspartame Transaminase (S.G.O.T) were done for them. Result: ?? patients (?? male,?? female),all patients had subclinical mild-moderate increased in liver enzymes ,one patient the (T.S.B.)had reached more than double upper normal level, while in ? patients the (A.L.T),and ?patients the (A.S.T.) had reached more than upper normal level, one patient had (TB DILI) we stopped give him ( R ,PZ) because more than double upper normal level of (T.S.B), (A.LT.)and (A.S.T.). Conclusion: Deranged liver function tests (L.F.Ts) are common in patients treated for Mycobacterium TB, but most patients are able to complete treatment. Routine LFT monitoring in patients without symptoms of hepatotoxicity is unlikely to affect treatment decisions. Recommendation: Deranged liver function tests (L.F.Ts) developed within the first ?months after initiating treatment. Patients taking anti- TB drugs should be followed biochemically during the initial phase of treatment than during the continuous phase and more frequently for those had clinical symptoms of hepatotoxicity or had risk factors.[Full Text Article]