# 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

## TL;DR

This study found that about 10% of 482 Chinese children with tuberculosis had abnormal liver function, and 4% had drug-induced liver injury, with certain treatment factors increasing the risk.

## Contribution

The study identifies specific risk factors for abnormal liver function and anti-tuberculosis drug-induced liver injury in pediatric patients.

## Key findings

- 18 out of 482 patients (3.73%) experienced anti-tuberculosis drug-induced liver injury.
- 51 patients (10.58%) had abnormal liver function during treatment.
- Use of second-line drugs in the intensive phase was a significant risk factor for both outcomes.

## Abstract

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.

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.

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).

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.