Non-Genetic Risk Factors of First Line Anti-Tuberculosis Drug-Induced Liver Injury in Active Pulmonary Tuberculosis Patients: A Systematic Review and Meta-Analysis
DOI:
https://doi.org/10.36497/jri.v45i3.693Keywords:
Tuberculosis, Drug-induced liver injury, First-line anti-tuberculosis, Pulmonary, Risk factorsAbstract
Background: Tuberculosis is still one of the leading causes of poor health and death worldwide. Drug-induced liver injury (DILI) is an important and serious side effect of anti-tuberculosis treatment and can cause non-adherence of patients to the treatment. To minimize the possibility of a person developing DILI due to anti-tuberculosis treatment, the risk factors present in the patient must be identified.
Methods: This systematic review was conducted based on the PRISMA 2020 statement. Inclusion and exclusion criteria were used to screen and filter the articles that have been obtained from literature searching performed through several journal databases. The extracted data were analyzed qualitatively and quantitatively. The quality of each study was also assessed using the modified Newcastle Ottawa Scale (NOS). The protocol for this systematic review has been registered with PROSPERO CRD42022384892.
Results: The result showed that, of the 13 studies analyzed qualitatively, 11 studies with a total of 4920 patients were continued for quantitative analysis. The factors analyzed and the results were female gender (OR 1.10 [0.72-1.67; p=0.65]), age over 40 years (OR 1.60 [1.04-2.46; p=0.03]), BMI less than 18.5 kg/m2 (OR 0.96 [0.52-1.79; p=0.9]), active smoking (OR 0.71 [0.34-1.49; p=0.36]), frequent alcohol intake (OR 1.44 [0.61-3.42; p=0.41]), hepatitis B (OR 3.42 [1.72-6.79; p<0.001]), and hepatitis C (OR 12.87 [6.67-24.86; p<0.00001]).
Conclusion: In conclusion, the evidence from this review suggests older age, hepatitis B, and hepatitis C are significant risk factors thought to increase the incidence of DILI in active pulmonary tuberculosis patients taking first line anti-tuberculosis regimens.
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