title: CYP2E1 polymorphism, acetylator profiles and drug-induced liver injury incidence of Indonesian tuberculosis patients.
abstract: OBJECTIVE
  A polymorphism of CYP2E1 may be directly associated with the development of INH hepatotoxicity. We conducted this study to evaluate the association between polymorphisms of CYP2E1, Isoniazid (INH) concentration and the acetylator status of INH in cases of Indonesian tuberculosis patients with drug-induced liver disease (DILI).
  
  
  METHODS
  We conducted our study with a cohort design consisting of 55 Indonesian adult tuberculosis (TB) patients. Acetylating phenotypes were studied in using the metabolic ratio of plasma AcHZ/HZ. DILI was defined using CTCAV version 4.0. The allelic and genotypic frequency distributions of CYP2E1 rs 3813867 were studied using the polymerase chain reaction - amplification refractory mutation system (ARMS) methodology.
  
  
  RESULTS
  Patients with an INH concentration of more than 7μg/mL showed a higher risk of developing DILI when compared with patients who showed a therapeutic range of 3-6μg/mL INH (OR: 1.3, 95% CI: 0.2-8.2). Slow acetylators had a higher incidence of DILI when compared with rapid acetylators (OR: 4.6, 95% CI: 1.3-15.9). Meanwhile, subjects with GC had a higher risk of DILI incidence (OR: 4.3, 95% CI: 0.8-24.4).
  
  
  CONCLUSIONS
  Our study shows that polymorphisms of CYP2E1 and slow acetylator may have role in the DILI incidence.
authors.affiliation: Postgraduate Program of Clinical Pharmacy, Faculty of Pharmacy, Ahmad Dahlan University, Jl prof Dr Soepomo, Janturan 55164, Yogyakarta, Indonesia. Electronic address: diahperwitasari2003@yahoo.com.
authors.forename: Dyah A
authors.initials: DA
authors.lastname: Perwitasari
authors.affiliation: Postgraduate Program of Clinical Pharmacy, Faculty of Pharmacy, Ahmad Dahlan University, Jl prof Dr Soepomo, Janturan 55164, Yogyakarta, Indonesia.
authors.forename: Lalu M
authors.initials: LM
authors.lastname: Irham
authors.affiliation: Postgraduate Program of Clinical Pharmacy, Faculty of Pharmacy, Ahmad Dahlan University, Jl prof Dr Soepomo, Janturan 55164, Yogyakarta, Indonesia.
authors.forename: Endang
authors.initials: E
authors.lastname: Darmawan
authors.affiliation: National Institute for Health Research and Development, Jl. Percetakan Negara 29, Jakarta Pusat 10560, Jakarta, Indonesia.
authors.forename: Ully A
authors.initials: UA
authors.lastname: Mulyani
authors.affiliation: Faculty of Medicine, Universitas Gadjah Mada, Jl. Farmako Sekip 55281, Yogyakarta, Indonesia.
authors.forename: J
authors.initials: J
authors.lastname: Atthobari
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects; D001191:Arylamine N-Acetyltransferase / Q000235:genetics*; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology* / Q000235:genetics; D019392:Cytochrome P-450 CYP2E1 / Q000235:genetics*; D060005:Genotyping Techniques; D006801:Humans; D015994:Incidence; D007214:Indonesia / Q000453:epidemiology; D007538:Isoniazid / Q000008:administration & dosage / Q000009:adverse effects; D020641:Polymorphism, Single Nucleotide; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics*
chemical_list: D000995:Antitubercular Agents; D019392:Cytochrome P-450 CYP2E1; D001191:Arylamine N-Acetyltransferase; D007538:Isoniazid
keywords: Acetylator status; CYP2E1; Hepatotoxicity; INH; Indonesian