Incidence and risk factors of abnormal liver function and anti-tuberculosis drug-induced liver injury: a multicenter retrospective study involving 482 chinese pediatric tuberculosis patients.

OBJECTIVE

This study aimed to investigate the incidence of abnormal liver function, which can lead to serious consequences, as well as anti-tuberculosis drug-induced liver injury (ATDILI) and their associated risk factors.

METHODS

A national multicenter retrospective study was conducted to collected pediatric TB treatment data from 11 specialized and general hospitals. The multivariate logistic regression analysis was performed to assess the influencing factors of abnormal liver function and ATDILI. The Kaplan-Meier survival analysis assessed temporal risk trends for these outcomes.

RESULTS

Among the 482 patients included in the study, 18 patients (3.73%) experienced ATDILI, and 51 (10.58%) experienced abnormal liver function. The time of occurrence of abnormal liver function and ATDILI was 20.0 (IQR: 6.0, 34.0) days and 28.0 (IQR: 8.0, 87.0) days, respectively. The multivariate analysis results showed that, patients who used second line drugs in the intensive phase were more likely to experience ATDILI (OR = 4.16, 95% CI: 1.34 ∼ 12.84, p = 0.013). Patients with severe TB and who used the second line drugs were more likely to develop abnormal liver function (OR = 2.31, 95% CI: 1.08 ∼ 4.97, p = 0.031 for severity; OR = 3.06, 95% CI: 1.46 ∼ 6.43, p = 0.003 for treatment).

CONCLUSION

The incidence of abnormal liver function and ATDILI differed. By considering laboratory indicators and clinical practice, early identification and detection of abnormal liver function in children during anti-TB treatment, along with timely intervention, can effectively prevent and control the harm caused by abnormal liver function and prevent it progression to ATDILI.