title: Cytochrome P450 pharmacogenetics in African populations: implications for public health.
abstract: BACKGROUND
  Africa harbors a disproportionate burden of disease when taking into account the triple challenge caused by HIV/AIDS, tuberculosis (TB) and malaria, against a backdrop of an increasing burden of noncommunicable diseases. More than 80% of therapeutic drugs used in the management of these diseases/conditions are metabolized by CYP enzymes that exhibit genetic polymorphisms.
  
  
  METHODS
  There is variability in the expression and activities of CYPs resulting in interindividual differences in the response to standard doses of therapeutic drugs, due to genetic polymorphisms, which exhibit both quantitative and qualitative differences between racial and between ethnic groups. The review aims to evaluate the implications of the genetic variation in CYPs on the public health of Africans. The CYPs reviewed here metabolize most of the commonly used therapeutic drugs and include CYP1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 3A4 and 3A5. Allele frequencies are compared between African ethnic groups and among populations of African, Asian and European origin. Data are obtained from our own studies and literature.
  
  
  CONCLUSIONS
  The variability in the pattern of genetic variation between populations translates into differences in drug response. Understanding CYP variability improves rational drug use and has public health significance.
authors.affiliation: University of Cape Town, Faculty of Health Sciences, Pharmacogenetics and Cancer Research Group, Division of Human Genetics, Department of Clinical Laboratory Sciences , Anzio Road Observatory, 7925, Cape Town , South Africa +27 21 406 6506 ; collet.dandara@uct.ac.za.
authors.forename: Collet
authors.initials: C
authors.lastname: Dandara
authors.forename: Marelize
authors.initials: M
authors.lastname: Swart
authors.forename: Bafokeng
authors.initials: B
authors.lastname: Mpeta
authors.forename: Ambroise
authors.initials: A
authors.lastname: Wonkam
authors.forename: Collen
authors.initials: C
authors.lastname: Masimirembwa
mesh_terms: D044466:Asian People / Q000235:genetics; D001711:Biotransformation / Q000235:genetics*; D044383:Black People / Q000235:genetics*; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics*; D005787:Gene Frequency; D006801:Humans; D011110:Polymorphism, Genetic; D011634:Public Health; D044465:White People / Q000235:genetics
chemical_list: D003577:Cytochrome P-450 Enzyme System
keywords: Africa; cytochrome P450; genetic diversity; genetics variation; pharmacogenetics; pharmacogenomics; public health