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Probiotics are promising in mitigating drug-induced liver injury in animal experiments. However, the clinical evidence is absent. The objective is to investigate the effect of adjunctive Lactobacillus casei on tuberculosis-drug-induced liver injury. A post hoc analysis was conducted for a previous randomized controlled trial. The trial was registered at the Chinese Clinical Trial Registry (No. ChiCTR-IOR-1701321. 429 patients were allocated to receive standard tuberculosis therapy alone (control group), or together with 1 × 10 colony-