NAT2 Genotype Pattern among Tuberculosis Patients Receiving Fixed-Dose Combination of Antituberculosis

Abstract

Abstract: Drug-induced liver injury (DILI) has known to be very responsible for more than 50% of acute liver failure cases in United States. Nowadays DILI’s treatment is only focused on supportive therapy as well as stopping the medication responsible for it. The incidence of antituberculosis liver injury (ATLI) in the world was ranging between 13-48%. Acetylator status and NAT2 genotype pattern related to it were two factors that have strong relationship to ATLI incidence. Slow acetylator was reported to significantly increase ATLI incidence in many studies. The proportion of slow acetylator were varies in many countries, ranging between 6-55% and these were strongly related to NAT2 genotype pattern. This study aimed to investigate NAT2 genotype pattern in tuberculosis patients receiving fixed-dose combination of antituberculosis. As many as 35 tuberculosis patients attending Outpatient Clinic of Sanglah Hospital were included in this cross sectional study. Identification of NAT2 genotype was performed with PCR-RFLP assay using KpnI and BamHI restriction enzymes. This study reveals the proportion of NAT2*4/*4; *4/*5 and *5/*5 genotype were 54.3%; 37.1%; dan 8.6%, respectively, whereas the proportion of NAT2*4/*4; *4/*7 and *7/*7 genotype were 11.4%; 71.4%; dan 17.2%, respectively. Keywords: antituberculosis, liver injury, N-acetyl transferase 2, acetylator, gene