Deşi preparatele antituberculoase de prima linie (isoniazida, rifampicina, pirazinamida, etambutolul) şi combinaţiile lor manifestă o efi cacitate înaltă acestea pot fi responsabile de reacţii adverse grave, inclusiv hepatotoxicitate. Patogeneza hepatotoxicităţii induse de preparatele antituberculoase poate fi determinată de doza medicamentului şi hipersensibilitatea la el. Factorii de risc ai hepatotoxicităţii sunt vârsta înaintată, malnutriţia, alcoolismul, hepatitele virale cronice, infecţia HIV, diabetul zaharat, afecţiunile tuberculoase extinse, polimorfi smul genetic etc. Efect protector pot manifesta silimarina, acidul alfa-lipoic, ademetionina, fosfolipidele esenţiale, tocoferolul etc.

Hepatoprotectors and hepatotoxicity of antituberculosis drugs Despite the great effi cacy of the fi rst line of antituberculosis drugs (isoniazid, rifampicin, pyrazinamide, etambutol) and its combinations can cause severe adverse reactions including hepatotoxicity. The patogenesis of drug/induced hepatotoxicity may be determined by a dose/ related toxicity and hypersensitivity to antituberculosis drugs. The factors of risc for drug/induced hepatotoxicity include old age, malnutrition, alcoholism, cronic viral hepatitis, HIV infection, extensive tuberculosis disease, genetic polymorphism. The potensial protective effect may be cauzed by silymarin, acid alpha/lipoic, ademethionine, essential phospholipids, tocopherol etc.