Incidence and Temporal Trend of Antituberculosis Drug-Induced Liver Injury: A Systematic Review and Meta-Analysis
Background and Aim. Antituberculosis (anti-TB) drug-induced liver injury (ATLI) is a common and serious adverse drug reaction of tuberculosis treatment, and the incidence of ATLI has been reported to vary from 2.0% to 28.0%. This study aims to estimate the incidence of ATLI in patients who receive a...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Journal of Tropical Medicine |
| Online Access: | http://dx.doi.org/10.1155/2022/8266878 |
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| author | Nannan Wang Xinyu Chen Zhuolu Hao Jia Guo Xuwen Wang Xijing Zhu Honggang Yi Qingliang Wang Shaowen Tang |
| author_facet | Nannan Wang Xinyu Chen Zhuolu Hao Jia Guo Xuwen Wang Xijing Zhu Honggang Yi Qingliang Wang Shaowen Tang |
| author_sort | Nannan Wang |
| collection | DOAJ |
| description | Background and Aim. Antituberculosis (anti-TB) drug-induced liver injury (ATLI) is a common and serious adverse drug reaction of tuberculosis treatment, and the incidence of ATLI has been reported to vary from 2.0% to 28.0%. This study aims to estimate the incidence of ATLI in patients who receive anti-TB treatment and describe its temporal trend in the world. Methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed, and the protocol was registered in PROSPERO (CRD42020200077). Five electronic databases were searched to identify eligible studies published between 1990 and 2022. Search terms included anti-TB treatment and drug-induced liver injury. Studies that reported the incidence of ATLI or provided sufficient data to calculate the incidence of ATLI were included, and duplicate studies were excluded. Meta-analysis was conducted on the basis of logit-transformed metrics for the incidence of ATLI with 95% confidence intervals (CIs), followed by a predefined subgroup meta-analysis. Temporal trend analyses were performed to describe the change in pooled incidence over time. A random effects metaregression was conducted to explore the source of heterogeneity. All statistical analyses were carried out using R 4.0.1. Results. A total of 160 studies from 156 records with 116147 patients were included in the meta-analysis. Based on the random effects model, the pooled incidence of ATLI was 11.50% (95% CI: 10.10%–12.97%) and showed an upward trend over time (P<0.001). Patients who received first-line anti-TB drugs, patients in South America, and patients with hepatitis B and C virus coinfection had a higher incidence of ATLI (13.66%, 18.16%, and 39.19%, respectively). Sensitivity analyses also confirmed this robust incidence after the exclusion of some studies. The metaregression showed that different anti-TB regimens and geographical regions were important explanatory factors of the heterogeneity between studies. Conclusions. The present systematic review provided a basis for estimating the incidence of ATLI worldwide, which varied among patients with different anti-TB regimens in different geographical regions and with different coinfections and had an upward trend. Regular liver function monitoring is imperative for patient safety during the anti-TB treatment course. |
| format | Article |
| id | doaj-art-4cf66f7aff044ff8b519e29b2da07a21 |
| institution | Kabale University |
| issn | 1687-9694 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Tropical Medicine |
| spelling | doaj-art-4cf66f7aff044ff8b519e29b2da07a212025-08-20T03:34:20ZengWileyJournal of Tropical Medicine1687-96942022-01-01202210.1155/2022/8266878Incidence and Temporal Trend of Antituberculosis Drug-Induced Liver Injury: A Systematic Review and Meta-AnalysisNannan Wang0Xinyu Chen1Zhuolu Hao2Jia Guo3Xuwen Wang4Xijing Zhu5Honggang Yi6Qingliang Wang7Shaowen Tang8Department of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsSchool of PharmacyFirst School of Clinical MedicineDepartment of Epidemiology and BiostatisticsDepartment of Medical AffairsDepartment of Epidemiology and BiostatisticsBackground and Aim. Antituberculosis (anti-TB) drug-induced liver injury (ATLI) is a common and serious adverse drug reaction of tuberculosis treatment, and the incidence of ATLI has been reported to vary from 2.0% to 28.0%. This study aims to estimate the incidence of ATLI in patients who receive anti-TB treatment and describe its temporal trend in the world. Methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were followed, and the protocol was registered in PROSPERO (CRD42020200077). Five electronic databases were searched to identify eligible studies published between 1990 and 2022. Search terms included anti-TB treatment and drug-induced liver injury. Studies that reported the incidence of ATLI or provided sufficient data to calculate the incidence of ATLI were included, and duplicate studies were excluded. Meta-analysis was conducted on the basis of logit-transformed metrics for the incidence of ATLI with 95% confidence intervals (CIs), followed by a predefined subgroup meta-analysis. Temporal trend analyses were performed to describe the change in pooled incidence over time. A random effects metaregression was conducted to explore the source of heterogeneity. All statistical analyses were carried out using R 4.0.1. Results. A total of 160 studies from 156 records with 116147 patients were included in the meta-analysis. Based on the random effects model, the pooled incidence of ATLI was 11.50% (95% CI: 10.10%–12.97%) and showed an upward trend over time (P<0.001). Patients who received first-line anti-TB drugs, patients in South America, and patients with hepatitis B and C virus coinfection had a higher incidence of ATLI (13.66%, 18.16%, and 39.19%, respectively). Sensitivity analyses also confirmed this robust incidence after the exclusion of some studies. The metaregression showed that different anti-TB regimens and geographical regions were important explanatory factors of the heterogeneity between studies. Conclusions. The present systematic review provided a basis for estimating the incidence of ATLI worldwide, which varied among patients with different anti-TB regimens in different geographical regions and with different coinfections and had an upward trend. Regular liver function monitoring is imperative for patient safety during the anti-TB treatment course.http://dx.doi.org/10.1155/2022/8266878 |
| spellingShingle | Nannan Wang Xinyu Chen Zhuolu Hao Jia Guo Xuwen Wang Xijing Zhu Honggang Yi Qingliang Wang Shaowen Tang Incidence and Temporal Trend of Antituberculosis Drug-Induced Liver Injury: A Systematic Review and Meta-Analysis Journal of Tropical Medicine |
| title | Incidence and Temporal Trend of Antituberculosis Drug-Induced Liver Injury: A Systematic Review and Meta-Analysis |
| title_full | Incidence and Temporal Trend of Antituberculosis Drug-Induced Liver Injury: A Systematic Review and Meta-Analysis |
| title_fullStr | Incidence and Temporal Trend of Antituberculosis Drug-Induced Liver Injury: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Incidence and Temporal Trend of Antituberculosis Drug-Induced Liver Injury: A Systematic Review and Meta-Analysis |
| title_short | Incidence and Temporal Trend of Antituberculosis Drug-Induced Liver Injury: A Systematic Review and Meta-Analysis |
| title_sort | incidence and temporal trend of antituberculosis drug induced liver injury a systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2022/8266878 |
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