Abstract: Objective To analyze the clinical characteristics of anti-tuberculosis drug-induced liver injury(ATB-DILI) patients co-infected with human immunodeficiency virus and mycobacterium tuberculosis(HIV-MTB). Methods The clinical data of 189 cases admitted to the people's hospital of Butuo county in Liangshan prefecture from October 2017 to October 2019 were retrospectively analyzed. Results Among 189 enrolled subjects, 111 cases(58.7%) were young and middle-aged married women, 149 cases(78.8%) were from rural areas, and 135 patients(71.4%) were infected with HIV through heterosexual contact. Most cases of DILI presented with hepatocellular injury(55.6%, Group A), followed by cholecystitis(32.3%, Group B) and mixed type(12.1%, Group C). Patients commonly presented with fatigue and appetit(61.9%), nausea and oil aversio(50.2%), jaundice43.9%), skin itchings(37.6%) and so on. In liver function examination, the ALT level of Group A was higher than that of Group B and Group C[(324.5±127.1)U/L, vs (217.3±86.4)U/L, (243.9±95.3)U/L)]. The ALP level of Group B was higher than that of Group A and Group C[(395.4±156.3)U/L vs (142.7±53.5)U/L, (272.5±101.4)U/L. The CD4+T lymphocyte count(＜200/μL) decreased significantly in 80 cases(42.3%), especially in Group A(175.9±71.3)/μL The abdominal imaging examinations in the three groups varied with no specificity. Conclusion The clinical manifestations of HIV-MTB co-infected patients combined with ATB-DILI are various, mainly presented with digestive system injury, and the prognosis of most patients is good. However, the early screening and intervention of ATB-DILI population in Liangshan prefecture still need to be strengthened.

Key words: Human immunodeficiency virus, Mycobacterium tuberculosis, Anti-tuberculosis drug-induced liver injury, Clinical characteristics