Interest of biochemical monitoring of liver function for patients under anti-tuberculosis treatment

Drug-induced hepatotoxicity (DIH) is an adverse reaction secondary to the administration of anti-tuberculosis (anti-TB) drugs. We aimed to evaluate the importance of implementing periodic liver function tests before and throughout the anti-TB treatment course. Liver function tests were performed on recruited patients at baseline and periodically throughout the anti-TB treatment course (10 days, 3 months, and 6 months). Test results were collected for the predictive biomarkers: aspartate amino-transferase (AST), alanine amino-transferase (ALT), alkaline phosphatase (ALP), total bilirubin (TBil), and conjugated bilirubin (BC). Some patients were surveyed about their treatment course and any adverse drug reactions (ADRs) caused by anti-TB drugs. The mean values for each of the following markers spiked by 10 days of treatment: AST (73.235 ± 77.632 IU/L), ALT (77.537 ± 95.737 IU/L), TBil (9.460 ± 8.254 mg/L), and BC (1.476 ± 0.730 mg/L), then gradually stabilized by 3 and 6 months of treatment (except for BC levels, which showed slight fluctuations). The mean concentration levels of ALP were gradually increasing after 10 days and 3 months of treatment. Furthermore, the mean levels at baseline were significantly different from the mean levels in both 10 days and 3 months of treatment, for each of the following markers: AST (p < 0.01), ALT (p < 0.01), TBil (p < 0.05), and BC (p < 0.05). In this study, predictive biomarkers of liver function witnessed varying patterns of fluctuation throughout the anti-TB treatment course. The adherence of practitioners to a more standardized approach to TB treatment is vital for the early management of DIH.