The effectiveness of managing hepatotoxic reactions when treating patients with anti-tuberculosis drugs

The incidence of hepatotoxic reactions on the back-ground of chemotherapy, based on publications, varies from 5.4 tо 85.7% [1–4]. Chemotherapy is number one when treating patients with tuberculosis. Seeking new highly efficient hepatoprotective agents is one of the main tasks of treatment. Оne of such drugs had been registered in July 2007 by the Ministry of Health of the RF as a highly efficient hepatoprotector to treat chronic liver diseases; the name of the drug being polyprenols’ concentrate ROPREN which stands for Russian prenols [8]. Aim of study: raise the efficiency of managing hepatotoxic reactions in patients with lung tuberculo-sis by using polyprenols’ concentrate. Маterials and methods: 64 patients with lung TB had been assessed. 59 patients (90.6%) received chemotherapy with 1st line anti-tuberculosis drugs (Isoniazid, Rifampicin, Pyrazina-mide, Ethambutol). 6 patients (9.4%) with multiple drug resistance received medications in accordance with data on M. tuberculosis drug susceptibility. While on therapy, 64 patients demonstrated the following side effects from the liver, ALT and AST increase not less than 2.5–3 times higher the upper limit of normal. All patients, depending on the hepatoprotective agents prescribed, have been divided into 2 groups: 1st group (37 patients) received polyprenols’ concentrate 6 drops 3 times a day for a month; control group (27 patients) received Phosphogliv 1 capsule 3 times a day for a month. Mean transaminas-es’ increase prior to hepatoprotective therapy in the main group were as follows: АLТ 200.56±125.9 U/l, АSТ 147.68±73.8 U/l; and in control group: АLТ 209.5±102.6 U/l, АSТ 164.0±91.9 U/l, respectively. Results. 2 weeks after the start of polyprenols’ concentrate intake a significant decrease of blood biochemical values were registered: АLТ tо 77.25±47.4 U/l and АSТ tо 53.06±28.9 U/l; 1 month after the start of therapy: АLТ tо 44.88±20.7 U/l and АSТ tо 41.37±23.1 U/l. Bilirubin values stayed within the nor-mal limits, р<0.05. In the group receiving Phosphogliv the blood biochemical values decreased as follows: 2 weeks after the start of therapy: АLТ tо 106.0±46.5 U/l and АSТ tо 71.23±33.3 U/l; 1 month after the start of therapy: АLТ tо 54.4±30.0 U/l and АSТ tо 40.41±15.6 U/l (р <0.05). Conclusion. The use of polyprenols’ concentrate leads to decrease of ALT significantly frequently compared to the control group 2 weeks after the start of therapy. By day 30 of therapy no significant difference between the groups was detected. There were no major adverse events throughout the period of drugs intake