[An evaluation of the side effects of anti Tuberculosis drugs in patients with Tuberculosis and factors affecting them in Imam Khomeini hospital]

ABSTRACT

During the course of treatment with anti - tuberculosis drugs in patients with pulmonary and extra pulmonary tuberculosis, unusual reactions such as hepatitis, rash, fever, flu like syndrome, neuropathy, . . . due to three potentially hepatotoxic drugs, Isoniazid, Rifampicin, and Pyrazinamide occur. Hepatotoxic reactions are vital because fulminant hepatic failure is devasting and may be fatal without liver transplantation. To determine the frequency and predisposing factors of drug reactions in patients managed with anti- tuberculosis drugs, we arranged retrospective case control study in Imam Khomeini Hospital.120 patients with hepatitis and other adverse reactions after receiving ant tuberculosis drugs in case groups and 240 patients without any drug reaction after receiving anti tuberculosis drugs in control group were evaluated. Most common adverse events were hepatitis 35.8%, abnormal liver enzyme without overt hepatitis 18.3%, skin rash 11.6% nausea and vomiting 8.3%, arthralgia 5.8%, flu like syndrome 5%. Old age more than 65 years [P=0.047], chronic liver disease [P= 0.008], renal failure [P=0.009], severe tuberculosis [P=0.001] and HIVIAIDS [P<0.039] were predisposing factors for adverse reaction in our patients. In conclusion, close monitoring for symptoms or signs of hepatitis among patients receiving anti-tuberculosis drugs especially old patients, who have chronic liver or kidney failure, patients with HIVI AIDS and patients with severe tuberculosis must be considered