Evidence map›Paper›PMID 41137008›Full record

ArticleBMC infectious diseases2025

Incidence and associated risk factors of anti-tuberculosis drug induced liver injury among TB patients.

Vincent Nyangwara, Ziyaad Waja, Roslyn Thelingwani, Raadhiya Osman, Ziska Pretorius, Keitumetse Majoro, Tom Boyles, Bekiwe Ncwana, Ananyo Choudhury, Collen Masimirembwa and 1 more

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Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Vincent NyangwaraDepartment of Bioanalytics, African Institute of Biomedical Science and Technology, Harare, Zimbabwe.
Ziyaad WajaPerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Roslyn ThelingwaniDepartment of Bioanalytics, African Institute of Biomedical Science and Technology, Harare, Zimbabwe.
Raadhiya OsmanPerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Ziska PretoriusPerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Keitumetse MajoroPerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Tom BoylesClinical HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
Bekiwe NcwanaPerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Ananyo ChoudhurySydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Collen Masimirembwa *Department of Bioanalytics, African Institute of Biomedical Science and Technology, Harare, Zimbabwe. cmasimirembwa@aibst.edu.zw.
Neil Martinson *Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa. Martinson@phru.co.za.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTuberculosis (TB) is a global health challenge. Use of anti-TB drugs to treat TB is associated with high prevalence of side effects that include anti-TB drug induced liver injury (ATDILI). The aim of this study was to determine the incidence and associated clinical risk factors of ATDILI among South African patients on treatment for TB disease.

methodsThis was an ambispective case-control study of patients on treatment for TB disease receiving drug sensitive and drug resistant treatment regimens. The retrospective and prospective studies were done from January 2021 to June 2024, involving a total of 610 patients on treatment for TB disease from whom 13 had ATDILI. From the retrospective and prospective cohorts, we extracted 13 ATDILI cases and 276 controls. Additionally, 44 severe ATDILI cases were directly recruited from the hospital to enrich the number of cases in the study. Prospective patients were followed for up to 6 months, while retrospective participants had a single visit with follow-up durations determined by their parent studies. Logistic regression analysis was performed to identify clinical and demographic factors associated with the development of ATDILI).

resultsIn the studied cohorts, the incidence of ATDILI was 2.1% (13/610). The ATDILI cases and controls consisted of 215 (64.6%) male patients; 57 patients were diagnosed with hepatotoxicity, 44 from the hospitalized cohort,12 from the retrospective cohort and 1 patient from the prospective cohort. The median time from the initiation of treatment to the onset of hepatotoxicity was approximately 30 days. Univariate logistic regression revealed significant differences (p < 0.05) in sex (p = 0.003), HIV status (p = 0.002), BMI (p = 0.038), hypertension (p = 0.047) smoking (p = 0.006), and alcohol consumption (p = 0.001) in relation to ATDILI. Multivariate analysis further revealed that female sex (p = 0.041), HIV status (0.022) and alcohol consumption (0.048) were independently associated with an increased risk of ATDILI.

conclusionsThe incidence of ATDILI in this study was 2.1%, lower than the previously reported range of 3–36% and highlights the need for standardized definitions of phenotypes across studies. In univariable analysis, female sex, HIV status, BMI, hypertension, smoking, and alcohol consumption were identified as potential risk factors for ATDILI. Among these, multivariable analysis suggested that female sex, HIV status and alcohol consumption were associated with an increased risk of developing ATDILI.

Indexed as

Antitubercular AgentsChemical and Drug Induced Liver InjuryTuberculosisAdultCase-Control StudiesFemaleHumansIncidenceMaleMiddle AgedProspective StudiesRetrospective StudiesRisk FactorsSouth AfricaYoung AdultAntitubercular AgentsAnti-tuberculosis regimensDrug induced liver injuryRisk factorsTuberculosis

Identifiers

PMID41137008
PMCPMC12551160

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.