Hepatotoxicity of antituberculosis therapy (rifampicin, isoniazid and pyrazinamide) or viral hepatitis

Abstract Setting: Department of Chest Diseases, Gazi University Faculty of Medicine and Ataturk Chest Diseases Hospital, Ankara, Turkey. Objective: The primary purpose of this study was to assess the contributory role of viral hepatitis in antituberculosis drug hepatotoxicity. Design: Serologic markers for viral hepatitis were studied in 57 patients who developed acute hepatitis during antituberculosis therapy with rifampicin and isoniazid. Results: Among 705 adult tuberculous patients, 57 (8.1%) developed acute hepatitis during therapy with rifampicin and isoniazid. Serologie markers confirmed the presence of hepatitis B in 6 (10.5%) and hepatitis C in 4 (7%) of the 57 patients. Acute hepatitis A was not diagnosed in any of the patients. Conclusion: Hepatitis occurring during antituberculosis therapy may not be drug-induced in all patients. Apart from the other factors mentioned above the endemicity of viral hepatitis in developing countries could be responsible for the higher incidence of antituberculosis-drug hepatitis.