Abstract
Introduction: The first-line antituberculosis (anti-TB) drugs associated with hepatotoxicity were documented in the pharmacokinetics and clinical practice. There are few ways to prevent the hepatotoxicity. Our aim is to study the hepatoprotective effect of N-acetylcysteine (NAC) on liver injury induced by anti-TB drugs.
Methods: A case-control study was conducted in the territory medical center and 379 TB patients with complete anti-TB drugs courses were recruited. 82 patients were prescribed NAC with 1200mg/day simultaneously (NAC group, NAC) and other 297 were not (placebo group, PL). The duration for anti-TB drugs treatment was at least 6 months. Liver enzymes and bilirubin levels were measured every 2 months, and whenever the patients presented with clinical symptoms of hepatotoxicity.
Results: There were no significant difference including age, sex, the duration and types of anti-TB drugs between the two groups. During the anti-TB drugs treatment period, 11 patients (13.4%) were diagnosed as having DIH in NAC group and 72 patients (24.2%) developed DIH in PL group (p<0.05). There was significant difference in the percentage of DIH in these two groups. Besides, the mean duration of treatment before the onset of hepatotoxicity was 28.6±14.9 days in NAC group, which is longer than in PL group with 17.4±11.3 days (p<0.01). Liver function became normalized within 9.4 ±6.7 days after stopping the anti-TB drugs in NAC group and was more rapid compared with 19.2±11.5 days in PL group (p<0.01).
Conclusion: NAC protects against anti-TB drug-induced hepatotoxicity.
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