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World J Gastroenterol. May 21, 2014; 20(19): 5760-5772
Published online May 21, 2014. doi: 10.3748/wjg.v20.i19.5760
Antitubercular therapy in patients with cirrhosis: Challenges and options
Naveen Kumar, Chandan Kumar Kedarisetty, Sachin Kumar, Vikas Khillan, Shiv Kumar Sarin
Naveen Kumar, Chandan Kumar Kedarisetty, Shiv Kumar Sarin, Departments of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, India
Sachin Kumar, Departments of Pulmonology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi-110070, India
Vikas Khillan, Departments of Microbiology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi-110070, India
Author contributions: All authors contributed to the manuscript.
Correspondence to: Dr. Shiv Kumar Sarin, MD, DM, DSc, FNA, Professor and Head, Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, Plot No.D-1, New Delhi 110070, India. shivsarin@gmail.com
Telephone: +91-11-46300000 Fax: +91-11-26123504
Received: October 29, 2013
Revised: December 31, 2013
Accepted: January 20, 2014
Published online: May 21, 2014
Core Tip

Core tip: Treatment of tuberculosis (TB) in patients with underlying cirrhosis is a challenge because of the compromised liver functions and high risk of hepatotoxicity. There is no consensus regarding the treatment and monitoring of TB in this group of patients. This paper reviews the differences in diagnosis, treatment, monitoring, hepatotoxicity and other issues in treatment of TB in patients with cirrhosis. Suggestions for treatment of TB in patients with different grades of cirrhosis, as well as monitoring guidelines, are provided. Finally, issues such as liver transplantation, multidrug-resistant TB and reactivation of TB by interferon are briefly reviewed.