UNIVERSITAS AIRLANGGA



Detail Article

Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 12 / No. 1 / Published : 2005-11

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Original Article :

Hepatotoxic effect of antituberculose drugs on aspartate amino transferase and alanine amino transferase levels in tuberculosis patients

Author :

  1. Delita Prihatni*1
  2. Ida Parwati*2
  3. I. Sjahid*3
  1. Laboratorium Patologi Klinik Fakultas Kedokteran UNPAD RS. Hasan Sadikin Bandung
  2. Laboratorium Patologi Klinik Fakultas Kedokteran UNPAD RS. Hasan Sadikin Bandung
  3. Laboratorium Patologi Klinik Fakultas Kedokteran UNPAD RS. Hasan Sadikin Bandung

Abstract :

Tuberculosis (TB) is still a major health problem, especially in the developing countries. The combination of antituberculosis drugsare generally recommended for the treatment of tuberculosis. Van Crevel study in Jakarta found that most (70%) of patients withpulmonary TB who received combined antituberculosis drugs with standard (450 mg) dose rifampicin had very low plasma rifampicinlevel. Based on this results, TB Research and Clinical Trial Centre Bandung & University Medical Centre Nijmegen, The Netherlandsconduct the study which compared clinical outcome between standard and high (600 mg) dose of rifampicin. Most of antituberculosisdrugs currently available are very low in causing acute and chronic toxicities, however we must keep aware of side effect duringthe treatment. The most serious adverse effect of several drugs is liver damage (drug induced hepatitis) and potentially fatal hepatitis.To detect liver demage earlier aspartate aminotransferase( AST) and alanine aminotransferase (ALT) serum level were examined duringantituberculosis treatment. The aim of this study was to determine AST and ALT serum level at intensif phase of antituberculosistreatment with standard and high dose rifampicin. The study had been done from August 2003 to September 2004 at Dr HasanSadikin Hospital and Balai Pengobatan Penyakit Paru- paru, Bandung. The subjects were divided randomly into 2 groups. The firstgroup consisted of patients with category I antituberculosis drugs with standard dose rifampicin and the second group patients alsocategory I with high dose rifampicin. Aspartate aminotransferase and ALT serum level were examined at week 0 (before treatment),2nd, 4th, and 8th. This was randomized clinical trial with paralel design study. Statistical analysis used paired t test to compare thedose effect of rifampicin to AST and ALT serum level changes, t independent test to compared mean difference of AST and ALT serumlevel changes which is projected by profile analysis. p value < 5%. The prevalence of the hepatotoxicity were 17.39% of standard doseand 18.17% of high dose rifampicin. The hepatotoxicity were mild and moderate level,and it was already present at 2 weeks oftherapy. There were no significant difference of AST and ALT serum level beetween those two groups. In this study antituberculosisdrugs with high dose rifampicin were safe for TB patients.

Keyword :

Hepatotoxicity, standard dose rifampicin and high dose rifampicin.,


References :

Jerant,(2000) Identification and Management of Tuberculosis. American Family Physician - : -

Bannon,(2000) Identification and Management of Tuberculosis. American Family Physician - : -

Rittenhouse,(2000) Identification and Management of Tuberculosis. American Family Physician - : -

WHO,(1996) World Health Organization global tuberculosis
programme-world TB day on March 24. WHO report on the
tuberculosis epidemic. Geneva : WHO

DKRI,(2002) Departemen Kesehatan Republik Indonesia,Pedoman
Nasional Penanggulangan Tuberkulosis. Cetakan ke 8. DirJen
P2M-PL. Departemen Kesehatan Jakarta. - : -

Van Crevel,(2002) Low plasma concentrations of rifampicin in tuberculosis patients in Indonesia. Dalam van Crevel R. Clinical and pathophysiological studies of tuberculosis. - : -

Alisjahbana,(2002) Low plasma concentrations of rifampicin in tuberculosis patients in Indonesia. Dalam van Crevel R. Clinical and pathophysiological studies of tuberculosis.



Archive Article

Cover Media Content

Volume : 12 / No. : 1 / Pub. : 2005-11
  1. The Microbiology Of Upper Respiratory Tract Infection On Surabaya’s Pilgrim Group 2004
  2. Determination Of Iron Deficiency In Chronic Disease Anemia By The Role Of Stfr-f Index
  3. Molecular Pathology Of Cerebrovascular Atherosclerosis
  4. Hypocolemic Periodic Paralysis
  5. Widal Tube Test Capability Using Imported Antigens And Local Antigens
  6. Increasing Quality Of Hospital Clinical Laboratory
  7. Cushing Syndrome In Pregnancy
  8. Hepatotoxic Effect Of Antituberculose Drugs On Aspartate Amino Transferase And Alanine Amino Transferase Levels In Tuberculosis Patients

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