Ivan Banjuradja*, Gurmeet Singh**

Abstrak Abnormalitas fungsi hati merupakan efek samping tersering pemberian regimen obat anti tuberkulosis (OAT) standar dimana menyebabkan 11% penghentian pemberian OAT pada pasien tuberkulosis (TB). Hepatotoksisitas terutama berhubungan dengan pemberian isoniazid (INH), rifampisin (RIF) dan pirazinamid (PZA) pada golongan OAT lini pertama. Manifestasi hepatotoksisitas bervariasi antara hanya berupa abnormalitas fungsi hati sampai kejadian gagal hati akut. Adapun pedoman tatalaksana TB dengan cedera hati akibat OAT sebagian besar masih didasarkan pada opini ahli. Dalam tinjauan pustaka ini akan dibahas mengenai mekanisme kelainan hati akibat OAT, tatalaksana penghentian, mekanisme reintroduksi OAT pada pasien-pasien yang mengalami kelainan fungsi hati, dan tatalaksana pengobatan pada pasien TB dengan riwayat gangguan fungsi hati sebelumnya.
Kata kunci: obat anti tuberkulosis, hepatotoksisitas
Abstract The abnormalities of liver function are the most common antitubercular side effect, which resulted in 11% drug discontinuation. Hepatotoxicity was mainly associated with the isoniazid (INH), rifampicin (RIF), and pyrazinamide (PZA) administration. The manifestation of hepatotoxicity was greatly varies, from asymptomatic abnormal liver function test to disastrous acute liver failure. Most of the recommendation for the management of liver injury related to antitubercular are based on expert opinion. This literature review will discuss the mechanism of antitubercular inducing liver injury, diagnostic work up, reintroduction of antitubercular, and management of tuberculosis in patients with previous liver dysfunction history.
Keywords: antitubercular, hepatotoxicity