BACKGROUND There are limited data available on whether drug-induced hepatotoxicity (DIH) affects the clinical outcomes of tuberculosis (TB) treatment. We explored the effects of DIH on the clinical course and outcomes of pulmonary TB. METHODS In this retrospective cohort study, we included patients with culture-proven pulmonary TB treated in a tertiary hospital from 2013 to 2016. DIH was defined as proposed by the official American Thoracic Society statement. We compared the clinical outcomes of DIH and non-DIH patients. RESULTS Between January 1, 2013 and December 31, 2016, a total of 168 TB patients were included, and 20 (11.9%) were diagnosed with DIH. These patients were significantly older, had a higher Charlson Comorbidity Index score, exhibited more chronic liver disease, included more chronic alcoholics, and had a lower body mass index than non-DIH patients. We found no significant differences between DIH and non-DIH patients in the 2-month sputum culture conversion rate, the time to sputum culture conversion, treatment outcomes, or total treatment duration. However, the ratio of treatment interruption time to total treatment duration and the proportion of hepatotonic users were significantly higher among DIH patients. CONCLUSION DIH development during TB treatment does not significantly affect the clinical outcomes of pulmonary TB. However, treatment interruption caused by DIH may increase the risks of future relapse and acquired resistance. Further study is needed.

中文翻译：

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药物性肝毒性对抗结核治疗的临床影响：一项病例对照研究。

背景技术关于药物诱发的肝毒性（DIH）是否影响结核病（TB）治疗的临床结果的可用数据有限。我们探讨了DIH对肺结核临床病程和预后的影响。方法在这项回顾性队列研究中，我们纳入了2013年至2016年在三级医院接受过文化验证的肺结核患者。DIH的定义是美国胸科学会的官方声明。我们比较了DIH和非DIH患者的临床结局。结果2013年1月1日至2016年12月31日，共纳入168 TB患者，其中20例（11.9％）被诊断出患有DIH。这些患者年龄较大，Charlson合并症指数更高，表现出更多的慢性肝病，包括更多的慢性酒精中毒，并且体重指数低于非DIH患者。我们发现DIH和非DIH患者在2个月的痰培养转化率，痰培养转化时间，治疗结果或总治疗持续时间方面无显着差异。然而，在DIH患者中，治疗中断时间与总治疗时间的比例以及肝细胞使用者的比例显着更高。结论结核病治疗期间DIH的发展不会显着影响肺结核的临床结局。但是，由DIH引起的治疗中断可能会增加将来复发和获得耐药的风险。需要进一步研究。治疗结果或总治疗时间。然而，在DIH患者中，治疗中断时间与总治疗时间的比例以及肝细胞使用者的比例显着更高。结论结核病治疗期间DIH的发展不会显着影响肺结核的临床结局。但是，由DIH引起的治疗中断可能会增加将来复发和获得耐药的风险。需要进一步研究。治疗结果或总治疗时间。然而，在DIH患者中，治疗中断时间与总治疗时间的比例以及肝细胞使用者的比例显着更高。结论结核病治疗期间DIH的发展不会显着影响肺结核的临床结局。但是，由DIH引起的治疗中断可能会增加将来复发和获得耐药的风险。需要进一步研究。DIH引起的治疗中断可能会增加将来复发和获得抵抗的风险。需要进一步研究。DIH引起的治疗中断可能会增加将来复发和获得抵抗的风险。需要进一步研究。