[Isoniazid acetylation in a group of Tunisian patients. Report of 620 patients].
Isoniazid is a first line antituberculosis drug metabolized mainly in the liver by the Nacetyltransferase. There are differences between individuals in acetylation metabolism. Subjects are thereby characterized as being rapid or slow acetylators. The purpose is to study the distribution pattern of acetylation in patients with tuberculosis followed up at the teaching Hospital of La Rabta. The determination of acetylator phenotype was carried out on 620 tuberculosis patients during a period of 12 years. There were 483 men and 137 women with a median age of 40.3 years. The test was investigated before drug regimen administration at the dose of 5 mg/kg. A blood sample was taken three hours after the first administration. The determination of acetylation profile was worked out by Vivien hypothesis. In our population 391 were low and 229 were fast acetylators. The median dose recommended within the test was 3.04 mg/kg/day. 56% of our patients were initially receiving high dose of isoniazid. An increase in serum transaminase was initially observed in 60 patients among whom 47 slow acetylators. After dose adaptation, 53 patients had improved their biological abnormalities. The majority of Tunisian population seem to belong to slow acetylators modal. The frequency of hepatotoxicity suggests reducing the recommended dose of isoniazid from 5 to 3 mg/kg/day.
Mehiri
Ben Rhouma Nadia
BR
Service de PneumoAllergologie, Hôpital La Rabta.
Zouaoui
Anissa
A
Chérif
Jouda
J
Ourari
Basma
B
Daghfous
Riadh
R
Oueslati
Mohamed Hédi
MH
Louzir
Bechir
B
Daghfous
Jalloul
J
Chelbi
Belkahia
B
Béji
Majed
M
D000107:Acetylation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000493:pharmacokinetics* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000378:metabolism; D014416:Tunisia
D000995:Antitubercular Agents; D007538:Isoniazid