Comprehensive review of anti-tubercular treatment induced liver injury.

ABSTRACT

The challenge in the management of tuberculosis is further compounded by the liver injury associated with anti-tubercular treatment (ATT) drugs. The problem of drug-induced liver injury (DILI) associated with ATT drugs is significant in the developing countries because of high disease burden, limited monitoring due to scarce resources and lack of awareness. There is heterogeneity in the pharmacokinetics and pharmacodynamics of the various first line ATT drugs. There are various genetic and environmental factors that affect DILI. Various guidelines have been proposed to treat and monitor DILI. This article reviews the problem, risk factors, mechanism, and management strategies of the DILI associated with ATT.