What monitoring is recommended for detecting hepatotoxicity during rifampin-containing TB therapy?

• A. Baseline and periodic liver function tests
• B. Monthly complete blood count only
• C. No liver monitoring
• D. Only symptom-based monitoring

Answer: (A)

Baseline and periodic liver function testing is the recommended approach for detecting hepatotoxicity during rifampin-containing TB therapy. Rifampin, along with other TB drugs, can injure the liver, and changes in liver enzymes may occur before symptoms appear. Starting with baseline LFTs establishes each patient’s normal values, allowing you to detect any rise early. Regular monitoring during treatment helps catch hepatotoxic changes as soon as they occur, so therapy can be adjusted promptly to prevent more serious liver injury. A complete blood count does not assess liver function, so it would miss the key signal. Relying only on symptoms can miss early toxicity because many patients do not have noticeable symptoms until substantial liver injury has happened. Although rifampin can cause hepatotoxicity, routine LFT monitoring remains recommended to ensure patient safety; any significant enzyme elevations or symptoms should prompt action.