Open Medicine Journal

ISSN: 1874-2203 ― Volume 7, 2020

Gender Differences and Treatment Outcome among Drug Induced Hepatotoxicity Tuberculosis Patients

Kamini Nadarajah1, Amer Hayat khan1, *, Irfhan Ali1, 2, Raja Ahsan Aftab1, 3, *, Imam Shaik4
1 Department of Clinical Pharmacy, School of Pharmaceutical Sciences Universiti Sains Malaysia, 11800 Penang, Malaysia
2 Department of Respiratory Medicine, Penang General Hospital, Penang, Malaysia
3 School of Pharmacy, Taylor’s University, Subang Jaya, Selangor, Malaysia
4 School of Medicine, Taylor’s University, Subang Jaya, Selangor, Malaysia


Aims and Objective:

The aim of the current manuscript is to determine the association between gender differences and drug-induced hepatotoxicity among patients receiving anti-tuberculosis therapy and to determine the outcome of the treatment.


A retrospective observational study was conducted among tuberculosis patients at Respiratory Clinic of Penang General Hospital (PGH) and Bukit Mertajam Hospital. A validated data collection instrument was used to collect patients’ demographic and clinical data confirmation of drug induced hepatotoxicity among tuberculosis patients was based on biochemical criteria which included 3 fold increase in liver enzymes in response to anti TB medication. All results were analyzed through SPSS version 20.


The study subjects were predominantly males 146 (76.8%) than females 44 (23.2%). Drug-induced hepatotoxicity with anti-tuberculosis drugs was observed the most among Chinese 90 (47%) ethnicity. Eighty-five (72%) male and 33 female (28%) tuberculosis drug-induced (TB-DIH) patients had a successful treatment outcome. Female patients had a statistically significant positive association with successful TB-DIH treatment outcomes (OR=1.83, 0.988-3.390 95%CI). Upon multivariate analysis, Indian ethnicity (OR = 0.173, p = 0.024), patients with relapse of Tuberculosis (TB) (OR= 0.332, p = 0.032) and Human Immune Virus (HIV) (OR= 0.217, p = 0.027) were less likely to have successful TB-DIH treatment outcomes.


Female Tuberculosis Drug Induced Hepatotoxicity (TB DIH) patients were more likely to have successful treatment outcomes. A number of factors such as Indian ethnicity, patients with relapse of Tuberculosis (TB) and patients with Human Immune Virus (HIV) were less likely to have successful TB DIH treatment outcomes.

Keywords: Gender differences, Drug-induced hepatotoxicity, Tuberculosis, Treatment outcomes, MDR-TB, Anti-tuberculosis therapy.

Article Information

Identifiers and Pagination:

Year: 2019
Volume: 6
First Page: 26
Last Page: 32
Publisher Id: MEDJ-6-26
DOI: 10.2174/1874220301906010026

Article History:

Received Date: 09/02/2019
Revision Received Date: 05/04/2019
Acceptance Date: 19/04/2019
Electronic publication date: 30/04/2019
Collection year: 2019

© 2019 Nadarajah et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to these authors at the Department of Clinical Pharmacy, School of Pharmaceutical Sciences Universiti Sains Malaysia, 11800 Penang, Malaysia and School of Pharmacy, Taylor’s University Jalan Taylors, Subang Jaya, Selangor Malaysia; Tel: 0060-175453546, 0060-172554387;

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