Evaluation of Prophylactic Role of Liver Supports in Patients Receiving Anti Tuberculous Therapy.

Abstract

Study objective: To study the possible role of liver supports in prevention (prophylaxis) of hepatitis/jaundice in patients receiving antituberculous therapy (ATT). Introduction: Drug induced hepatotoxicity is a major problem arising in patients receiving antituberculous therapy and has been well documented. There are many liver supports available in the pharmaceutical market like silymerin and ornithine aspartate etc. which claim to have a potent effect in reducing the hepatotoxicity induced by ATT or other drugs. This study was conducted to see whether they have any true fact in the claim of prevention of hepatotoxicity induced by ATT. Materials and methods: The study was conducted from 01-06-03 to 30 06-04. A total of two hundred and four (204) patients suffering with tuberculosis were enrolled. These patients were divided into two equal groups (randomly). Group A was started standard first line antituberculous therapy without liver support. Group B received liver support in some form. The patients in group B were further divided into 3 sub-groups. Two subgroups received one of the two liver supports and the third subgroup received both. These patients were followed weekly for eight weeks (by measuring liver function tests) for any evidence of hepatotoxicity. Hepatotoxicity was defined as serum bilirubin more than 1.0 mg/dL and/or liver enzymes greater than four times the base-line value. Results: Among 204 patients, 16 patients developed hepatotoxicity. Out of which 6 belonged to group A (with out liver support), 4 to group B-l (silymerin), 4 to group B-2 (ornithine), while 2 to group B-3. Conclusion: We conclude that there is no statistically significant difference (p value >.o5) in the incidence of hepatitis in both groups.