ReviewJournal of clinical and experimental hepatology2012
A guide to the management of tuberculosis in patients with chronic liver disease.
Review in Journal of clinical and experimental hepatology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 71 citations in OpenAlex.
- Tuberculosis in Cirrhosis: A Diagnostic and Therapeutic Challenge.Digestive diseases and sciences · 2026Review
- Child-Turcotte-Pugh score-based modified anti-tubercular treatment in patients with decompensated cirrhosis with tuberculosis: A two-year retrospective observational study from North India.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Observational
- HBV/HCV coinfection and anti-tuberculosis drug-induced liver injury: from risk assessment and exploration of mechanisms to preventive considerations.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Review
- Abnormal Liver Function at the Time of Tuberculosis Diagnosis in South India.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2026Article
- Triple infection with pulmonary tuberculosis, chronic hepatitis C and systemic brucellosis in an HIV/AIDS patient: a case report from northwestern China.Frontiers in medicine · 2026Article
- Anti-Tubercular Drug-Induced Liver Injury: Current Understanding and Emerging Directions.JGH open : an open access journal of gastroenterology and hepatology · 2026Review
- Transcriptomic insights intoThe veterinary quarterly · 2025Article
- Side Effects of First-Line Anti-tubercular Therapy (ATT): Does an Alternative Regimen Exist?Cureus · 2025Article
- Latent TB treatment outcomes in patients with chronic liver disease: A retrospective cohort study.Journal of clinical tuberculosis and other mycobacterial diseases · 2025Article
- Understanding antituberculosis drug-induced hepatotoxicity: Risk factors and effective management strategies in the pediatric population.World journal of clinical pediatrics · 2025Review
- Article
- Article
- A true challenge: Disseminated tuberculosis with tuberculous meningitis in a patient with underlying chronic liver disease.IDCases · 2024Article
- Vaccination in liver diseases and liver Transplantation: Recommendations, implications and opportunities in the post-covid era.JHEP reports : innovation in hepatology · 2023Review
- An Insight into Advances in Developing Nanotechnology Based Therapeutics, Drug Delivery, Diagnostics and Vaccines: Multidimensional Applications in Tuberculosis Disease Management.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Diagnosis of tuberculosis with autoimmune hepatitis-systemic lupus erythematosus overlap syndrome: a case report.Journal of medical case reports · 2022Article
- Anti-tuberculosis drug-induced liver injury in patient with hepatitis B and cirrhosis: A case report.Annals of medicine and surgery (2012) · 2022Article
- Clinical standards for the dosing and management of TB drugs.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
- Nonviral Infections of the Liver in Developing Countries.Clinical liver disease · 2022Review
- Difficulties in Diagnosing and Treating Disseminated Bacillus Calmette-Guérin (BCG) Infection After Intravesical BCG Therapy in a Patient with Liver Cirrhosis: A Case Report.The American journal of case reports · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Tuberculosis remains one of the 'Captains of the Men of Death' even today, particularly in the developing world. Its frequency is increased 14-fold in patients with chronic liver diseases (CLD) and liver cirrhosis, more so in those with decompensated disease, probably due to the cirrhosis-associated immune dysfunction syndrome, and case-fatality rates are high. The diagnosis of tuberculosis, particularly the interpretation of the Mantoux test, is also fraught with difficulties in CLD, especially after previous BCG vaccination. However, the greatest challenge in the patient with CLD or liver cirrhosis and tuberculosis is managing their therapy since the best first-line anti-tuberculosis drugs are hepatotoxic and baseline liver function is often deranged. Frequency of hepatotoxicity is increased in those with liver cirrhosis, chronic hepatitis B and chronic hepatitis C, possibly related to increased viral loads and may be decreased following antiviral therapy. If hepatotoxicity develops in those with liver cirrhosis, particularly decompensated cirrhosis, the risk of severe liver failure is markedly increased. Currently, there are no established guidelines for anti-tuberculosis therapy (ATT) in CLD and liver cirrhosis although the need for such guidelines is self-evident. It is proposed that ATT should include no more than 2 hepatotoxic drugs (RIF and INH) in patients with CLD or liver cirrhosis and stable liver function [Child-Turcotte-Pugh (CTP) ≤7], only a single hepatotoxic drug (RIF or INH) in those with advanced liver dysfunction (CTP 8-10) and no hepatotoxic drugs with very advanced liver dysfunction (CTP ≥11). A standard protocol should be followed for monitoring ATT-related hepatotoxicity and for stop rules and reintroduction rules in all these patients, on the lines proposed here. It is hoped that these proposals will introduce uniformity and result in streamlining the management of these difficult patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.