Abstract: Objective To explore the effects of positive hepatitis B surface antigen (HBsAg) on liver injury caused by anti-tuberculosis (TB) drugs. Methods One hundred and eight patients with positive HBsAg out of 190 pulmonary TB cases visited the station from February 2010 to January 2014 were enrolled in the observation group, and the other 82 cases with negative HBsAg were in control group. The status of liver function damage and degree of damage after anti-TB treatment of the two groups were compared. SPSS 19.0 was used for data analysis. t test was applied in comparison of quantitative data and Chi-square test was used in the comparison of categorical variables．P<0.05 was considered statistically significant. Results The liver damage rate of observation group (30.56%, 33/108) was significantly higher than that of the control group (12.20%, 10/82), and the difference was statistically significant (χ²=8.974，P<0.05). The liver damage rates of observation group increased with the severing infection of hepatitis B virus (HBV)(singal positive; HBsAg, HBeAb, and HBcAb test positive; HBsAg, HBeAg, and HBcAb test positive), which were 15.52% (9/58), 35.48% (11/31) and 68.42% (13/19) respectively. The differences of the liver damage rates among different degree of HBV infection were significant (HBsAg, HBeAb, and HBcAb test positive vs single positive: χ²=4.623, P<0.05; HBsAg, HBeAg, and HBcAb test positive vs single positive: χ² =1.963, P<0.05; HBsAg, HBeAg, and HBcAb test positive vs HBsAg, HBeAb, and HBcAb test positive: χ²=5.120, P<0.05). The alanine aminotransferase (ALT) and total bilirubin (TBL) of observation group were (394.25±48.39)U/L and (91.83±19.02) μmol/L, which were significantly higher than those of the control group ((247.61±52.48) U/L and (48.15±12.91) μmol/L)(t=19.946,18.828, all P<0.01). The recovery time from liver damage of observation group (28.09±15.32) day was significantly longer than that of the control group (11.26±7.34) day (t=10.004, P<0.01). Conclusion The liver damage induced by anti-TB drugs of patients with positive HBsAg is significantly more serious than that of patients with negative HBsAg, and liver damage aggravates with the severing infection of HBV, so that positive HBsAg has obvious effects on liver damage induced by anti-TB drugs.

Key words: Tuberculosis, pulmonary/drug therapy, Antitubercular Agents, Drug-induced liver injury, Hepatitis B surface antigens