The relationship between relative telomere length and anti-tuberculosis drug-induced hepatitis : A case-control study

Aim. - Anti-tuberculosis drug-induced hepatitis (AT-DIH) is a common and serious adverse drug reaction of tuberculosis treatment. Evidence demonstrated that many factors could affect the occurrence of AT-DIH, such as ageing, smoking, alcohol, oxidative stress, etc., while these factors could also promote telomere shortening. Therefore, relative telomere length (RTL) is indirectly related to the occurrence of AT-DIH. The present study aimed to explore and validate this relationship in Chinese tuberculosis patients. Methods. - A 1:4 matched case-control study was undertaken using 202 AT-DIH cases and 808 controls. Logistic regression models were used to estimate the association between RTL and AT-DIH with odds ratios (ORs) and 95% confidence intervals (CIs). The area under receiver operating characteristic curve (AUC) was calculated to estimate the discriminative performance for distinguishing AT-DIH cases from controls. Results. - The average RTL in AT-DIH cases was significantly shorter than that in controls (1.24 vs. 1.46, P = 0.002). Patients with longer RTL were at a reduced risk of AT-DIH (OR = 0.79, 95% CI: 0.66-0.94, P = 0.009), and a dose-response relationship also existed between RTL and lower AT-DIH risk (P for trend = 0.012). Under the optimal RTL cut-off value of 1.22, the corresponding AUCs were 0.57 (95% CI: 0.53-0.62, P = 0.001) in the univariate model and 0.62 (95% CI: 0.57-0.66, P < 0.001) in the multivariate model. Conclusion. - This study showed that the shorter the RTL, the higher the risk of AT-DIH during an anti-tuberculosis treatment. The short RTL could potentially serve as a risk factor or a predictive test of the hepatotoxic risk associated with anti-tuberculosis treatments. (c) 2022 Societe francaise de pharmacologie et de therapeutique. Published by Elsevier Masson SAS. All rights reserved.