Which statement about liver function monitoring during TB therapy is correct?

• A. Stop offending drugs when hepatotoxicity occurs and monitor LFTs, then reintroduce sequentially
• B. Do not monitor LFTs unless symptoms appear
• C. Monitor LFTs only after therapy ends
• D. Liver function testing is unnecessary

Answer: (A)

Liver safety during TB treatment hinges on recognizing that certain anti-TB drugs can injure the liver and acting quickly to protect it. The best approach is to stop the drugs that are causing hepatotoxicity and give the liver time to recover, then reintroduce the medications one by one while closely watching liver tests. This stepwise reintroduction helps identify which drug is triggering the injury and allows you to complete therapy with the minimum risk of recurrent liver damage. Baseline liver tests and regular monitoring during treatment are essential because liver injury can occur even before symptoms appear. Waiting for symptoms or waiting until after therapy ends would miss subclinical injury and put the patient at greater risk.