Determination of Isoniazid Acetylator Phenotype and its Clinical Implication in Rwandan Tuberculosis Patients

Mukanyangezi, MF; Kadima, NJ; Musemakweri, Andre

doi:10.4314/rjhs.v2i1.1f

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Although NAT2 acetylator phenotypes are dependent on not only genotypic factors but also various environmental conditions, this genotypic information could, in part, explain the disparities seen between the metabolic responses of the failed and cured patients. The correlating NAT2 phenotypes of these patients could, however, not be confirmed since these tests require a controlled experimental design, − which did not fall within the scope of this project at the time of sample collection.…”

Section: Discussionmentioning

confidence: 94%

Chronological Metabolic Response to Intensive Phase TB Therapy in Patients with Cured and Failed Treatment Outcomes

et al. 2021

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Despite the arguable success of the standardized tuberculosis (TB) treatment regime, a significant number of patients still present with treatment failure. To improve on current TB treatment strategies, we sought to gain a better understanding of the hosts’ response to TB therapy. A targeted metabolomics approach was used to compare the urinary acylcarnitine and amino acid profiles of eventually cured TB patients with those of patients presenting with a failed treatment outcome, comparing these patient groups at the time of diagnosis and at weeks 1, 2, and 4 of treatment. Among the significant metabolites identified were histidine, isoleucine, leucine, methionine, valine, proline, tyrosine, alanine, serine, and γ-aminobutyric acid. In general, metabolite fluctuations in time followed a similar pattern for both groups for most compounds but with a delayed onset or shift of the pattern in the successfully treated patient group. These time-trends detected in both groups could potentially be ascribed to a vitamin B6 deficiency and fluctuations in the oxidative stress levels and urea cycle intermediates, linked to the drug-induced inhibition and stimulation of various enzymes. The earlier onset of observed trends in the failed patients is proposed to relate to genotypic and phenotypic variations in drug metabolizing enzymes, subsequently leading to a poor treatment efficiency either due to the rise of adverse drug reactions or to insufficient concentrations of the active drug metabolites. This study emphasizes the need for a more personalized TB treatment approach, by including enzyme phenotyping and the monitoring of oxidative stress and vitamin B6 levels, for example.

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Section: Discussionmentioning

confidence: 94%

Chronological Metabolic Response to Intensive Phase TB Therapy in Patients with Cured and Failed Treatment Outcomes

et al. 2021

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Effect of TB Therapy on the Health and Nutritional Status of Infants Aged 6 Months to 5 Years Diagnosed with Latent TB

Tebandite¹,

Muyobela²,

Lusamaki³

et al. 2018

JTR

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Background: Infants with latent tuberculosis are often subject to high morbidity, nutritional deficiency and mortality. Early treatment can prevent the onset of TB by reducing morbidity and improving nutritional status. This paper assessed whether preventive chemotherapy for TB can improve health and nutritional status of infants diagnosed with latent TB in Kisangani City. Method: Children diagnosed TB+ by tuberculin skin test and other clinical examinations were treated with Rifampicin, Isoniazid, Pyrazinamide and Ethambutol. Clinical symptoms and nutritional status were determined before to start treatment and at the 5 th month of treatment. Results: Out of 161 infants treated, 73 (45.3%) were <1 year old, 49 (30.4%) were 1-2 years old and 39 (24.2%) were 3-5 years old. Both boys and girls were almost equally represented (50.3/49.7%). The proportion of infants with fever (T > 37˚C) was 62.7% before treatment and 17.4% at the 5 th month of treatment; the difference was statistically significant (p < 0.001). Similarly, the proportion of children with weights below the ideal weight adjusted for each age decreased from 21.7% before treatment to 8.1% after treatment. Infants younger than one year were more likely to have fever than older children, while girls were more likely to be malnourished than boys (p < 0.05) before treatment, but the recovery rates were not different. Conclusion: Treatment of infants diagnosed of latent TB prevents TB disease and improves nutritional status, but not in all cases. Control of fever and weight gain can be an indicator of good How to cite this paper:

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Determination of Isoniazid Acetylator Phenotype and its Clinical Implication in Rwandan Tuberculosis Patients

Cited by 2 publications

References 12 publications

Chronological Metabolic Response to Intensive Phase TB Therapy in Patients with Cured and Failed Treatment Outcomes

Chronological Metabolic Response to Intensive Phase TB Therapy in Patients with Cured and Failed Treatment Outcomes

Effect of TB Therapy on the Health and Nutritional Status of Infants Aged 6 Months to 5 Years Diagnosed with Latent TB

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