Risk factors associated with anti-tubercular therapy-induced hepatitis in human immunodeficiency virus seropositive and seronegative patients in India

Background People living with Human Immunodeficiency Virus (PLW-HIV) on anti-retroviral therapy are more likely to develop tuberculosis as compared to people without HIV. The objective of the study is to evaluate the risk factors, prevalence, and management pattern of Anti-tubercular therapy-induced hepatitis (ATT-IH) in PLW-HIV with Anti-Retroviral Therapy (ART) in comparison with HIV-SNP. Methodology A retrospective observational cohort study was conducted at a university teaching hospital for Anti-tubercular therapy-induced hepatitis ATT-IH. Patients were screened based on International Classification of Diseases codes 10. A total of N = 431 patients with ATT-IH (250 males and 181 females) were included in the study. The severity grading of ATT-IH was assessed by Liver Tox. The risk factors associated with ATT-IH in HIV-SPP and HIV-SNP were assessed and determined at a p value <0.05. Results Out of 431 patients with ATT-IH, 231 patients experienced ATT-IH in the HIV-SP group and 200 patients in the HIV-SN group. Zero-inflated regression analysis identified risk factors for ATT-IH in HIV-SPP in comparison with HIV-SNP, including BMI, hepatitis B, and smoking habits. The prevalence of ATT-IH in HIV-SPP was 53.6% and 46.4% in HIV-SNP. A higher incidence of 23 (10 %) of ATT-IH was reported with the Tenofovir + Lamivudine + Lopinavir+ Ritonavir ART regimen. Conclusion Clinicians must focus on early detection of risk factors for ATT-IH in HIV-SPP in comparison with HIV-SNP to prevent significant hepatic complications.