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The susceptibility of anti-tuberculosis drug-induced liver injury and chronic hepatitis C infection: A systematic review and meta-analysis
Anti-tuberculosis drug-induced liver injury (ATDILI) is a major safety concern in the treatment of tuberculosis (TB). The impact of chronic hepatitis C (CHC) infection on the risk of ATDILI is still controversial. We aimed to assess the influence of CHC infection on ATDILI through a systematic revie...
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| Published in: | Journal of the Chinese Medical Association 2018-02, Vol.81 (2), p.111-118 |
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| container_end_page | 118 |
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| container_title | Journal of the Chinese Medical Association |
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| creator | Chang, Tien-En Huang, Yi-Shin Chang, Chih-Hao Perng, Chin-Lin Huang, Yi-Hsiang Hou, Ming-Chih |
| description | Anti-tuberculosis drug-induced liver injury (ATDILI) is a major safety concern in the treatment of tuberculosis (TB). The impact of chronic hepatitis C (CHC) infection on the risk of ATDILI is still controversial. We aimed to assess the influence of CHC infection on ATDILI through a systematic review and meta-analysis.
We systemically reviewed all English-language literature in the major medical databases with the subject search terms “anti-tuberculosis drug-induced liver injury” and “anti-tuberculosis drug-induced hepatotoxicity”. We then performed a systematic review and meta-analysis of the papers relevant to hepatitis C in qualified publications.
A total of 14 studies were eligible for analysis, which included 516 cases with ATDILI and 4301 controls without ATDILI. The pooled odds ratio (OR) of all studies for CHC infection to ATDILI was 3.21 (95% confidence interval (CI): 2.30–4.49). Subgroup analysis revealed that the CHC carriers had a higher risk of ATDILI than those without CHC both in Asians (OR = 2.96, 95% CI: 1.79–4.90) and Caucasians (OR = 4.07, 95% CI: 2.70–6.14), in those receiving standard four combination anti-TB therapy (OR = 2.94, 95% CI: 1.95–4.41) and isoniazid monotherapy (OR = 4.18, 95% CI: 2.36–7.40), in those with a strict definition of DILI (serum alanine aminotransferase [ALT] > 5 upper limit of normal value [ULN], OR = 2.59, 95% CI: 1.58–4.25) and a loose definition of DILI (ALT > 2 or 3 ULN, OR = 4.34, 95% CI: 2.96–6.37), and in prospective studies (OR = 4.16, 95% CI: 2.93–5.90) and case–control studies (OR = 2.43, 95% CI: 1.29–4.58).
This meta-analysis suggests that CHC infection may increase the risk of ATDILI. Regular liver tests are mandatory for CHC carriers under anti-TB therapy. |
| doi_str_mv | 10.1016/j.jcma.2017.10.002 |
| format | article |
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We systemically reviewed all English-language literature in the major medical databases with the subject search terms “anti-tuberculosis drug-induced liver injury” and “anti-tuberculosis drug-induced hepatotoxicity”. We then performed a systematic review and meta-analysis of the papers relevant to hepatitis C in qualified publications.
A total of 14 studies were eligible for analysis, which included 516 cases with ATDILI and 4301 controls without ATDILI. The pooled odds ratio (OR) of all studies for CHC infection to ATDILI was 3.21 (95% confidence interval (CI): 2.30–4.49). Subgroup analysis revealed that the CHC carriers had a higher risk of ATDILI than those without CHC both in Asians (OR = 2.96, 95% CI: 1.79–4.90) and Caucasians (OR = 4.07, 95% CI: 2.70–6.14), in those receiving standard four combination anti-TB therapy (OR = 2.94, 95% CI: 1.95–4.41) and isoniazid monotherapy (OR = 4.18, 95% CI: 2.36–7.40), in those with a strict definition of DILI (serum alanine aminotransferase [ALT] > 5 upper limit of normal value [ULN], OR = 2.59, 95% CI: 1.58–4.25) and a loose definition of DILI (ALT > 2 or 3 ULN, OR = 4.34, 95% CI: 2.96–6.37), and in prospective studies (OR = 4.16, 95% CI: 2.93–5.90) and case–control studies (OR = 2.43, 95% CI: 1.29–4.58).
This meta-analysis suggests that CHC infection may increase the risk of ATDILI. Regular liver tests are mandatory for CHC carriers under anti-TB therapy.</description><identifier>ISSN: 1726-4901</identifier><identifier>EISSN: 1728-7731</identifier><identifier>DOI: 10.1016/j.jcma.2017.10.002</identifier><identifier>PMID: 29198550</identifier><language>eng</language><publisher>Netherlands: Elsevier Taiwan LLC</publisher><subject>Anti-tubercular agent ; Anti-Tuberculosis drug-induced liver injury ; Antitubercular Agents - adverse effects ; Chemical and Drug Induced Liver Injury - etiology ; Disease Susceptibility ; Drug-induced liver injury ; Hepatitis C ; Hepatitis C, Chronic - complications ; Humans ; Meta-analysis ; Tuberculosis</subject><ispartof>Journal of the Chinese Medical Association, 2018-02, Vol.81 (2), p.111-118</ispartof><rights>2017</rights><rights>Copyright © 2017. Published by Elsevier Taiwan LLC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-b6ff34a6af7cfb55c5264e7e91cdc9e630fc4692394af627f0171029e75da8443</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29198550$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, Tien-En</creatorcontrib><creatorcontrib>Huang, Yi-Shin</creatorcontrib><creatorcontrib>Chang, Chih-Hao</creatorcontrib><creatorcontrib>Perng, Chin-Lin</creatorcontrib><creatorcontrib>Huang, Yi-Hsiang</creatorcontrib><creatorcontrib>Hou, Ming-Chih</creatorcontrib><title>The susceptibility of anti-tuberculosis drug-induced liver injury and chronic hepatitis C infection: A systematic review and meta-analysis</title><title>Journal of the Chinese Medical Association</title><addtitle>J Chin Med Assoc</addtitle><description>Anti-tuberculosis drug-induced liver injury (ATDILI) is a major safety concern in the treatment of tuberculosis (TB). The impact of chronic hepatitis C (CHC) infection on the risk of ATDILI is still controversial. We aimed to assess the influence of CHC infection on ATDILI through a systematic review and meta-analysis.
We systemically reviewed all English-language literature in the major medical databases with the subject search terms “anti-tuberculosis drug-induced liver injury” and “anti-tuberculosis drug-induced hepatotoxicity”. We then performed a systematic review and meta-analysis of the papers relevant to hepatitis C in qualified publications.
A total of 14 studies were eligible for analysis, which included 516 cases with ATDILI and 4301 controls without ATDILI. The pooled odds ratio (OR) of all studies for CHC infection to ATDILI was 3.21 (95% confidence interval (CI): 2.30–4.49). Subgroup analysis revealed that the CHC carriers had a higher risk of ATDILI than those without CHC both in Asians (OR = 2.96, 95% CI: 1.79–4.90) and Caucasians (OR = 4.07, 95% CI: 2.70–6.14), in those receiving standard four combination anti-TB therapy (OR = 2.94, 95% CI: 1.95–4.41) and isoniazid monotherapy (OR = 4.18, 95% CI: 2.36–7.40), in those with a strict definition of DILI (serum alanine aminotransferase [ALT] > 5 upper limit of normal value [ULN], OR = 2.59, 95% CI: 1.58–4.25) and a loose definition of DILI (ALT > 2 or 3 ULN, OR = 4.34, 95% CI: 2.96–6.37), and in prospective studies (OR = 4.16, 95% CI: 2.93–5.90) and case–control studies (OR = 2.43, 95% CI: 1.29–4.58).
This meta-analysis suggests that CHC infection may increase the risk of ATDILI. Regular liver tests are mandatory for CHC carriers under anti-TB therapy.</description><subject>Anti-tubercular agent</subject><subject>Anti-Tuberculosis drug-induced liver injury</subject><subject>Antitubercular Agents - adverse effects</subject><subject>Chemical and Drug Induced Liver Injury - etiology</subject><subject>Disease Susceptibility</subject><subject>Drug-induced liver injury</subject><subject>Hepatitis C</subject><subject>Hepatitis C, Chronic - complications</subject><subject>Humans</subject><subject>Meta-analysis</subject><subject>Tuberculosis</subject><issn>1726-4901</issn><issn>1728-7731</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9UctuFDEQtCIQCYEf4IB85DKL7Zmx14hLtEpIpEhcwtnyeNrZHs1j8SNofoGvxpsNHDnZ6q6qVlUR8oGzDWdcfh42g5vsRjCuymDDmDgjF1yJbaVUzV89_2XVaMbPydsYB8YaqXX7hpwLzfW2bdkF-f2wBxpzdHBI2OGIaaWLp3ZOWKXcQXB5XCJG2of8WOHcZwc9HfEJAsV5yGEt2J66fVhmdHQPB5swFfyurD24hMv8hV7RuMYEU9k5GuAJ4dczbYJkKzvbcS0n3pHX3o4R3r-8l-THzfXD7ra6__7tbnd1X7mGsVR10vu6sdJ65XzXtq4VsgEFmrveaZA18674FLVurJdC-RIPZ0KDanu7bZr6knw66R7C8jNDTGbC4n8c7QxLjoZrJWomaskLVJygLiwxBvDmEHCyYTWcmWMHZjDHDsyxg-OsdFBIH1_0czdB_4_yN_QC-HoCQHFZsggmOoS5BIuhJGb6Bf-n_wddQ5re</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Chang, Tien-En</creator><creator>Huang, Yi-Shin</creator><creator>Chang, Chih-Hao</creator><creator>Perng, Chin-Lin</creator><creator>Huang, Yi-Hsiang</creator><creator>Hou, Ming-Chih</creator><general>Elsevier Taiwan LLC</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201802</creationdate><title>The susceptibility of anti-tuberculosis drug-induced liver injury and chronic hepatitis C infection: A systematic review and meta-analysis</title><author>Chang, Tien-En ; Huang, Yi-Shin ; Chang, Chih-Hao ; Perng, Chin-Lin ; Huang, Yi-Hsiang ; Hou, Ming-Chih</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-b6ff34a6af7cfb55c5264e7e91cdc9e630fc4692394af627f0171029e75da8443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Anti-tubercular agent</topic><topic>Anti-Tuberculosis drug-induced liver injury</topic><topic>Antitubercular Agents - adverse effects</topic><topic>Chemical and Drug Induced Liver Injury - etiology</topic><topic>Disease Susceptibility</topic><topic>Drug-induced liver injury</topic><topic>Hepatitis C</topic><topic>Hepatitis C, Chronic - complications</topic><topic>Humans</topic><topic>Meta-analysis</topic><topic>Tuberculosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Tien-En</creatorcontrib><creatorcontrib>Huang, Yi-Shin</creatorcontrib><creatorcontrib>Chang, Chih-Hao</creatorcontrib><creatorcontrib>Perng, Chin-Lin</creatorcontrib><creatorcontrib>Huang, Yi-Hsiang</creatorcontrib><creatorcontrib>Hou, Ming-Chih</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the Chinese Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Tien-En</au><au>Huang, Yi-Shin</au><au>Chang, Chih-Hao</au><au>Perng, Chin-Lin</au><au>Huang, Yi-Hsiang</au><au>Hou, Ming-Chih</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The susceptibility of anti-tuberculosis drug-induced liver injury and chronic hepatitis C infection: A systematic review and meta-analysis</atitle><jtitle>Journal of the Chinese Medical Association</jtitle><addtitle>J Chin Med Assoc</addtitle><date>2018-02</date><risdate>2018</risdate><volume>81</volume><issue>2</issue><spage>111</spage><epage>118</epage><pages>111-118</pages><issn>1726-4901</issn><eissn>1728-7731</eissn><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-1</notes><notes>ObjectType-Review-4</notes><notes>content type line 23</notes><notes>ObjectType-Undefined-3</notes><abstract>Anti-tuberculosis drug-induced liver injury (ATDILI) is a major safety concern in the treatment of tuberculosis (TB). The impact of chronic hepatitis C (CHC) infection on the risk of ATDILI is still controversial. We aimed to assess the influence of CHC infection on ATDILI through a systematic review and meta-analysis.
We systemically reviewed all English-language literature in the major medical databases with the subject search terms “anti-tuberculosis drug-induced liver injury” and “anti-tuberculosis drug-induced hepatotoxicity”. We then performed a systematic review and meta-analysis of the papers relevant to hepatitis C in qualified publications.
A total of 14 studies were eligible for analysis, which included 516 cases with ATDILI and 4301 controls without ATDILI. The pooled odds ratio (OR) of all studies for CHC infection to ATDILI was 3.21 (95% confidence interval (CI): 2.30–4.49). Subgroup analysis revealed that the CHC carriers had a higher risk of ATDILI than those without CHC both in Asians (OR = 2.96, 95% CI: 1.79–4.90) and Caucasians (OR = 4.07, 95% CI: 2.70–6.14), in those receiving standard four combination anti-TB therapy (OR = 2.94, 95% CI: 1.95–4.41) and isoniazid monotherapy (OR = 4.18, 95% CI: 2.36–7.40), in those with a strict definition of DILI (serum alanine aminotransferase [ALT] > 5 upper limit of normal value [ULN], OR = 2.59, 95% CI: 1.58–4.25) and a loose definition of DILI (ALT > 2 or 3 ULN, OR = 4.34, 95% CI: 2.96–6.37), and in prospective studies (OR = 4.16, 95% CI: 2.93–5.90) and case–control studies (OR = 2.43, 95% CI: 1.29–4.58).
This meta-analysis suggests that CHC infection may increase the risk of ATDILI. Regular liver tests are mandatory for CHC carriers under anti-TB therapy.</abstract><cop>Netherlands</cop><pub>Elsevier Taiwan LLC</pub><pmid>29198550</pmid><doi>10.1016/j.jcma.2017.10.002</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of the Chinese Medical Association, 2018-02, Vol.81 (2), p.111-118 |
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| source | BACON - Elsevier - GLOBAL_SCIENCEDIRECT-OPENACCESS; HEAL-Link subscriptions: Lippincott Williams & Wilkins; IngentaConnect Journals |
| subjects | Anti-tubercular agent Anti-Tuberculosis drug-induced liver injury Antitubercular Agents - adverse effects Chemical and Drug Induced Liver Injury - etiology Disease Susceptibility Drug-induced liver injury Hepatitis C Hepatitis C, Chronic - complications Humans Meta-analysis Tuberculosis |
| title | The susceptibility of anti-tuberculosis drug-induced liver injury and chronic hepatitis C infection: A systematic review and meta-analysis |
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