Predicting drug-induced liver injury from anti-tuberculous medications by early monitoring of liver tests

•Routine 2-week liver tests were evaluated in a 1247 patient cohort treated for TB. •Anti-tuberculous therapy (ATT) led to drug-induced injury (DILI) 8.3%. •Risk of late TB-DILI increased 2.2-fold every 30 U/L rise pre-treatment ALT. 2.1-fold gradient ALT change. Objective Tuberculosis Drug Induced Liver Injury (TB-DILI) is common and potentially severe complication associated with anti-tuberculous treatment (ATT). Optimal test monitoring standard TB medication has not been established. We describe the predictive value (LTs) at 2-weeks after initiation ATT detection TB-DILI. Methods Patients initiating monitored routine LTs 2-weeks. Logistic regression models constructed retrospectively identify variables ‘late’ (>2 weeks initiation) whether alanine aminotransferase (ALT) levels could predict Results patients active tuberculosis managed 5 sites across north west London between January 2015 December 2018 LTs. 103 cases (8.3%) ATT-associated DILI diagnosed. 60 (58.3%) occurred later than The risk was greater increment (OR 2.16, 95% CI 1.38–3.29 p<0.001) 2.06, 1.52–2.76 p<0.001). Conclusion Routine capture early may be valuable predicting on ATT.