Incidence, risk factors, and outcomes of anti-tuberculosis drug-induced hepatotoxicity in people with and without HIV in Thailand and the Philippines.

IF 1.4 4区医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Asian Biomedicine Pub Date : 2026-06-30 eCollection Date: 2026-06-01 DOI:10.2478/abm-2026-0020

Ryan Christopher Geturbos Atuel, Emmanuel A Gutierrez, Napon Hiranburana, Tanakorn Apornpong, Sasiwimol Ubolyam, Ma Tarcela S Gler, Anchalee Avihingsanon, Sivaporn Gatechompol, Stephen J Kerr

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引用次数: 0

Abstract

Background: Anti-tuberculosis drug-induced hepatotoxicity (DIH) is a common complication among people living with HIV (PLWH), potentially leading to treatment interruptions.

Objective: To determine the incidence of DIH and identify risk factors in Thai and Filipino PLWH on tuberculosis (TB) treatment, compared with those with TB mono-infection.

Methods: We conducted a cohort study of Thai and Filipino adults with active TB using retrospective data from Thailand (2000-2024) and prospective data from the Philippines (2024). DIH was defined as AST or ALT ≥3 times the upper limit of normal. Logistic regression was used to assess DIH risk factors among PLWH; TB treatment outcomes were compared by DIH status.

Results: Among 222 participants (138 PLWH, 84 HIV-negative), median age was 38 years, 63% were male, and median body mass index (BMI) was 18.2 kg/m². DIH occurred in 13.8% of PLWH and 9.5% of HIV-negative individuals (P = 0.35), with median onset at 10 and 3 weeks, respectively. Among PLWH, hepatitis C co-infection (aOR 5.84, 95% CI 1.51-22.55, P = 0.01) and lower BMI (aOR 0.78/kg/m², 95% CI 0.63-0.97, P = 0.03) were independently associated with DIH. Dolutegravir use showed a non-significantly lower DIH risk (OR 0.51, 95%CI, 0.18 - 1.42). TB treatment success was similar between those with and without DIH (92.6% vs 90.3%); mortality was slightly higher with DIH (3.7% vs 1.5%).

Conclusions: Hepatitis C co-infection and low BMI are key risk factors for DIH among PLWH receiving TB treatment. Despite these risks, DIH did not significantly impact treatment outcomes.

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泰国和菲律宾艾滋病毒感染者和非艾滋病毒感染者中抗结核药物引起的肝毒性的发生率、危险因素和结局

背景：抗结核药物引起的肝毒性（DIH）是HIV感染者（PLWH）的常见并发症，可能导致治疗中断。目的：比较泰国和菲律宾接受结核病治疗的PLWH患者与单感染结核病患者的DIH发病率及危险因素。方法：我们对泰国和菲律宾成人活动性结核病患者进行了一项队列研究，使用泰国（2000-2024）的回顾性数据和菲律宾（2024）的前瞻性数据。DIH定义为AST或ALT≥正常上限的3倍。采用Logistic回归评估PLWH患者的DIH危险因素；结核病治疗结果与DIH状况进行比较。结果：222名参与者（138名PLWH， 84名hiv阴性）中位年龄为38岁，63%为男性，中位体重指数（BMI）为18.2 kg/m2。13.8%的PLWH患者和9.5%的hiv阴性患者发生DIH (P = 0.35)，中位发病时间分别为10周和3周。在PLWH中，丙型肝炎合并感染（aOR 5.84, 95% CI 1.51 ~ 22.55, P = 0.01）和较低BMI （aOR 0.78/kg/m2, 95% CI 0.63 ~ 0.97, P = 0.03）与DIH独立相关。Dolutegravir的使用显示DIH风险无显著降低（OR 0.51, 95%CI, 0.18 - 1.42）。结核病治疗成功率在患有和不患有DIH的患者之间相似（92.6% vs 90.3%）；DIH的死亡率略高（3.7% vs 1.5%）。结论：丙型肝炎合并感染和低BMI是接受结核病治疗的PLWH患者发生DIH的关键危险因素。尽管存在这些风险，但DIH并未显著影响治疗结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Biomedicine 医学-医学：研究与实验

CiteScore

1.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Asian Biomedicine: Research, Reviews and News (ISSN 1905-7415 print; 1875-855X online) is published in one volume (of 6 bimonthly issues) a year since 2007. [...]Asian Biomedicine is an international, general medical and biomedical journal that aims to publish original peer-reviewed contributions dealing with various topics in the biomedical and health sciences from basic experimental to clinical aspects. The work and authorship must be strongly affiliated with a country in Asia, or with specific importance and relevance to the Asian region. The Journal will publish reviews, original experimental studies, observational studies, technical and clinical (case) reports, practice guidelines, historical perspectives of Asian biomedicine, clinicopathological conferences, and commentaries Asian biomedicine is intended for a broad and international audience, primarily those in the health professions including researchers, physician practitioners, basic medical scientists, dentists, educators, administrators, those in the assistive professions, such as nurses, and the many types of allied health professionals in research and health care delivery systems including those in training.