Incidence of N-acetyltransferase 2 Genotype Testing of Tuberculosis Patients in a Provincial Hospital, Northeastern of Thailand
DOI:
https://doi.org/10.64960/srimedj.v41i5.271706Keywords:
NAT-2 gene, tuberculosis, isoniazid, hepatotoxicity, pharmacogenomicsAbstract
Background and objectives: Genetic polymorphisms of the N-acetyltransferase 2 (NAT-2 gene) gene play a crucial role in the metabolism of isoniazid and are associated with adverse drug reactions, particularly hepatotoxicity in patients with tuberculosis. This study aimed to investigate the incidence and distribution of NAT2 genotypes, as well as their association with hepatotoxicity among tuberculosis patients.
Methods: A retrospective study was conducted using medical records of tuberculosis patients who underwent NAT-2 gene at Roi Et Hospital between October 2021 and December 2023. A total of 343 patients were included. Descriptive statistics and Chi-square test.
Results: Among the 343 patients, the distribution of acetylator phenotypes was as follows: intermediate acetylators 43.1%, ultra-slow acetylators 34.4%, rapid acetylators 13.7%, and slow acetylators 8.7%. The incidence of hepatotoxicity was lower in rapid and intermediate acetylators 11.9% and 15.5%, respectively, whereas it was markedly higher in slow and ultra-slow acetylators 51.9% and 50.4%, respectively. In terms of treatment outcomes, most patients in the rapid and intermediate acetylator groups were able to tolerate standard dosing regimens. In contrast, patients in the slow and ultra-slow acetylator groups were more likely to require dose adjustments, particularly dose reduction of isoniazid or modification of treatment regimens, due to hepatotoxicity.
Conclusions: This study demonstrates that genetic polymorphisms of the NAT2 gene are strongly associated with the development of hepatotoxicity in patients with tuberculosis receiving isoniazid. The incidence of hepatotoxicity varies significantly across acetylator phenotypes. Specifically, the slow and ultra-slow acetylator groups showed markedly higher incidence rates (51.9% and 50.4%, respectively), whereas the rapid and intermediate acetylator groups had substantially lower incidence rates (11.9% and 15.5%, respectively). In addition, the distribution of acetylator phenotypes in this population was predominantly intermediate and ultra-slow, highlighting the importance of close monitoring for hepatotoxicity in these patient groups.
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