Title: Vitamin D status among Pulmonary Tuberculosis Drug Induced Hepatotoxicity of Anti-tubercular Therapy
Authors: Ishan Parasher, Amit Jha, Suryakant Nagtilak, Naresh Kumar, Amit Mittal
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.119
Abstract
Background: Serum 25-hydroxy vitamin D (S-25(OH) D), in pulmonary Tubercular patient enhances host protective immune response to mycobacterium tuberculosis (TB) and reduces disease associated inflammation. The aim of present study is to evaluate correlation between S-25(OH) D levels, Body mass index (BMI) and albumin in drug induced hepatotoxicity (DIH) under Directly Observed Therapy Short course (DOTS) treatment.
Methods: Total of 107 (70 male, 37 female) age-sex matched pulmonary TB control and 58 (38 male, 20 female) DIH patients, age grouped 20-70 years, were included in the study. Anthropometric measurements, Liver function test (LFT), S-25(OH)D, biochemical, radiological and microbial markers were computed. Biochemical marker assessment was performed on 1st, 4th, 8th and 16th week in all study patients and P-values by unpaired t test of various parameters obtained on 1st and 16th week were calculated.
Results: The comparative study of S-25(OH)D, Albumin and BMI in control TB and DIH patient under ATT on 1st and 16th week showed significant differences. DIH patients showed S-25(OH)D level deficient (less than 20 ng/ml) in comparison to non-DIH patient insufficient value (20-29 ng/ml) under chemotherapy (P < 0.0001). BMI was found less in DIH patients than control but the statistics were insignificant (P < 0.118). Hypoalbuminemia was seen in DIH patient where as control albumin levels were in baseline (P < 0.039).
Conclusions: The pulmonary TB patients having DIH should be supplied with higher doses of S-25(OH)D to accelerate the radiological and immunological recovery as deficient levels of vitamin D worsen the severity of infection.
Keywords: Tuberculosis, S-25(OH)D, Innate immunity, Immuno-modulatory activity, Drug Induced Hepatotoxicity.
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