Acute liver failure from anti-tuberculosis drug-induced liver injury: An update

doi:10.4254/wjh.v17.i5.106618

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May 27, 2025 (publication date) through Mar 1, 2026

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World Journal of Hepatology

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1948-5182

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World J Hepatol. May 27, 2025; 17(5): 106618
Published online May 27, 2025. doi: 10.4254/wjh.v17.i5.106618

Acute liver failure from anti-tuberculosis drug-induced liver injury: An update

Ramesh Kumar, Abhishek Kumar, Sudhir Kumar

Ramesh Kumar, Abhishek Kumar, Sudhir Kumar, Department of Gastroenterology, All India Institute of Medical Sciences, Patna 801507, India

Author contributions: Kumar R and Kumar A designed the concept, collected the data and wrote the manuscript; Kumar S collected the data and wrote the manuscript; all authors have read and approved the final manuscript.

Conflict-of-interest statement: None of authors have any conflict of interest related to this work.

Corresponding author: Ramesh Kumar, MD, Department of Gastroenterology, All India Institute of Medical Sciences, Phulwari Sharif, Patna 801507, India. docrameshkr@gmail.com

Received: March 4, 2025
Revised: April 1, 2025
Accepted: May 10, 2025
Published online: May 27, 2025
Processing time: 85 Days and 20.1 Hours

Core Tip

Core Tip: Tuberculosis (TB) remains a significant public health concern in developing countries. First-line anti-TB drugs (ATDs) pose a risk of drug-induced liver injury (DILI), which can progress to acute liver failure (ALF), a life-threatening condition. The global incidence of ATD-induced DILI is approximately 11.5%, with around 7% of cases progressing to ALF within two months of treatment initiation. Notably, young female patients are disproportionately affected by this condition, which is clinically indistinguishable from other causes of ALF and is associated with a high mortality rate, necessitating emergency liver transplantation. This minireview provides a comprehensive overview of ATD-induced ALF, covering epidemiology, risk factors, and treatment options.