Pyridoxal-5-phosphate plasma concentrations in children receiving tuberculosis chemotherapy including isoniazid.
OBJECTIVE
Little is known about pyridoxine nutriture of children treated with isoniazid (INH) regimens. This study documents plasma pyridoxal 5'-phosphate (PLP) concentrations in children, HIV-infected and HIV-uninfected, receiving INH regimens.


METHODS
Children from the Western Cape of South Africa hospitalized for tuberculosis (TB) management were studied. Plasma PLP concentrations were determined on enrolment, 1-month after commencing TB treatment, and again after 4-month's treatment. The children received a supplement meeting pyridoxine requirements.


RESULTS
Nineteen HIV-infected and 33 HIV-uninfected children received INH (dosage range 4-20 mg/kg) daily. Mean PLP plasma concentrations on enrolment were 8.32 (SD 6.75) ng/mL and 11.28 (SD 3.02) ng/mL in HIV-infected and HIV-uninfected children, respectively (p = 0.11) and after 4-month's treatment 6.75 (SD 2.71) ng/mL and 14.76 (SD 7.96) ng/mL (p < 0.001). On enrolment 9 (50%) HIV-infected and 5 (15%) HIV-uninfected children (p = 0.016) had suboptimal PLP concentrations (<6 ng/mL); after 4-month's treatment 8 (42%) and 2 (6%) (p = 0.004).


CONCLUSIONS
Plasma PLP concentrations in children treated for TB were low on enrolment in HIV-infected and HIV-uninfected children; after 4-month's treatment low values were still common in HIV-infected children. Additional pyridoxine supplementation of malnourished children treated for tuberculosis is advisable, particularly those HIV-infected.
Department of Human Nutrition, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaHuman Sciences Research Council, Knowledge Systems, Cape Town, South AfricaDepartment of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, South AfricaBiostatistics Unit of the South African Medical Research Council, Cape Town, South AfricaDivision of Molecular Biology and Human Genetics and the MRC Centre for Molecular and Cellular Biology, DST/NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaInstitute of Infectious Diseases and Molecular Medicine, University of Cape Town, Rondebosch 7701, South Africa.
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Cilliers
Department of Human Nutrition, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaHuman Sciences Research Council, Knowledge Systems, Cape Town, South AfricaDepartment of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, South AfricaBiostatistics Unit of the South African Medical Research Council, Cape Town, South AfricaDivision of Molecular Biology and Human Genetics and the MRC Centre for Molecular and Cellular Biology, DST/NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaInstitute of Infectious Diseases and Molecular Medicine, University of Cape Town, Rondebosch 7701, South Africa.
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Labadarios
Department of Human Nutrition, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaHuman Sciences Research Council, Knowledge Systems, Cape Town, South AfricaDepartment of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, South AfricaBiostatistics Unit of the South African Medical Research Council, Cape Town, South AfricaDivision of Molecular Biology and Human Genetics and the MRC Centre for Molecular and Cellular Biology, DST/NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaInstitute of Infectious Diseases and Molecular Medicine, University of Cape Town, Rondebosch 7701, South Africa.
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Schaaf
Department of Human Nutrition, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaHuman Sciences Research Council, Knowledge Systems, Cape Town, South AfricaDepartment of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, South AfricaBiostatistics Unit of the South African Medical Research Council, Cape Town, South AfricaDivision of Molecular Biology and Human Genetics and the MRC Centre for Molecular and Cellular Biology, DST/NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaInstitute of Infectious Diseases and Molecular Medicine, University of Cape Town, Rondebosch 7701, South Africa.
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Willemse
Department of Human Nutrition, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaHuman Sciences Research Council, Knowledge Systems, Cape Town, South AfricaDepartment of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, South AfricaBiostatistics Unit of the South African Medical Research Council, Cape Town, South AfricaDivision of Molecular Biology and Human Genetics and the MRC Centre for Molecular and Cellular Biology, DST/NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaInstitute of Infectious Diseases and Molecular Medicine, University of Cape Town, Rondebosch 7701, South Africa.
J S
JS
Maritz
Department of Human Nutrition, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaHuman Sciences Research Council, Knowledge Systems, Cape Town, South AfricaDepartment of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, South AfricaBiostatistics Unit of the South African Medical Research Council, Cape Town, South AfricaDivision of Molecular Biology and Human Genetics and the MRC Centre for Molecular and Cellular Biology, DST/NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaInstitute of Infectious Diseases and Molecular Medicine, University of Cape Town, Rondebosch 7701, South Africa.
C J
CJ
Werely
Department of Human Nutrition, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaHuman Sciences Research Council, Knowledge Systems, Cape Town, South AfricaDepartment of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, South AfricaBiostatistics Unit of the South African Medical Research Council, Cape Town, South AfricaDivision of Molecular Biology and Human Genetics and the MRC Centre for Molecular and Cellular Biology, DST/NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaInstitute of Infectious Diseases and Molecular Medicine, University of Cape Town, Rondebosch 7701, South Africa.
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Hussey
Department of Human Nutrition, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaHuman Sciences Research Council, Knowledge Systems, Cape Town, South AfricaDepartment of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University and Tygerberg Children's Hospital, Tygerberg, South AfricaBiostatistics Unit of the South African Medical Research Council, Cape Town, South AfricaDivision of Molecular Biology and Human Genetics and the MRC Centre for Molecular and Cellular Biology, DST/NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Tygerberg 7505, South AfricaInstitute of Infectious Diseases and Molecular Medicine, University of Cape Town, Rondebosch 7701, South Africa.
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Donald
D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000188:drug therapy*; D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007223:Infant; D007538:Isoniazid / Q000627:therapeutic use*; D008297:Male; D011732:Pyridoxal Phosphate / Q000097:blood*; D013019:South Africa; D014376:Tuberculosis / Q000097:blood / Q000150:complications / Q000188:drug therapy*
D000995:Antitubercular Agents; D011732:Pyridoxal Phosphate; D007538:Isoniazid