Liver Function Monitoring during the Intensive Phase of Tuberculosis Treatment: A Case Study in Western Kenya

Background: Tuberculosis (TB) remains a major public health concern worldwide, despite the availability of effective therapies for many decades. It continues to contribute significantly to illness, disability and mortality. While treatment is effective, adverse drug reactions affecting the liver can complicate management and undermine therapeutic success. Establishing multifaceted pharmacovigilance approaches provides the most viable avenues of understanding patient needs and appropriate response.
Objective: This study aimed to assess the prevalence of hepatic impairment caused by anti-tuberculosis drugs among newly diagnosed patients receiving treatment for drug-sensitive tuberculosis.
Methodology: The study was conducted among participants aged 18 years and above.
Results: The Aspartate Transaminase (AST) and Alanine Transaminase (ALT) individually presented no noticeable significance both at initial and during treatment. However, the AST/ALT ratio remained significantly high possibly due to slow recovery after TB induced muscle wastage. There was a significant elevation of alkaline phosphatase (ALP) for cases at baseline, median 269.5 U/L, p value < 0.0001 but reduced to 243.0, p value 0.056. Total protein was within reference range but with low albumin and higher globulin values at baseline, p value < 0.0001, this improved over treatment duration, p = 0.093
Conclusion: Alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) tests provided additional value in the diagnosis of extra pulmonary tuberculosis and treatment monitoring.