Research Article
Volume 7 Issue 10 - 2020
Drug Induced Liver Injury in HIV-Infected Patients during Antituberculosis Therapy
Kliaritskaia IL1* and Shelikhova EO2
1Medical Academy Named After S. I. Georgievsky, Russia
2Crimean Federal University Named After V. I. Vernadsky, Russia
*Corresponding Author: Kliaritskaia IL, Medical Academy Named After S. I. Georgievsky, Russia.
Received: August 17, 2020; Published: September 15, 2020




Abstract

Objective: Value of genotyping of cytochrome P450 2E 1 and NAT2 enzymes in prediction of drug induced liver injury (DILI) in patients with pulmonary tuberculosis and in HIV-coinfected patients who are undergoing antituberculosis and antiretroviral therapy.

Materials and Methods: 200 patients were examined during the study. Patients with or without drug-induced liver disease on the background of anti-tuberculosis chemotherapy were studied by genotyping of cytochrome P450 2E 1 and NAT2 enzymes by “real time” polymerase chain reaction (PCR) and 13C-metacetin breath test.

Results: In the 2nd group and in the 4th group (in groups of patients with drug-induced liver disease on the background of anti-tuberculous therapy), slow acetylators and genotype of cytochrome P450 2E 1 c1/c1 prevailed.

Conclusion: It is advisable to recommend patients in the high-risk group for the development of drug-induced liver injury to determine the activity of cytochrome P450 2E 1 and NAT2 enzymes by genotyping and phenotyping in order to select the optimal scheme of anti-tuberculosis therapy, which will lead to increased adherence of patients to therapy and improvement of patients’ quality of life.

Keywords: Human Immunodeficiency Virus; Pulmonary Tuberculosis; DILI-Drug Induced Liver Injury

References

  1. Plan to Stop TB in 18 High-priority Countries in the WHO European Region, 2007-2015. World Health Organization (2020).
  2. Eefje Jong., et al. “Guideline Consensus statement: Management of drug-induced liver injury in HIV-positive patients treated for TB”. Southern African Journal of HIV Medicine 3 (2013).
  3. Global tuberculosis report. Geneva, Switzerland: WHO. World Health Organization. WHO/ (2013).
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  5. Klyarytskaya IL., et al. “Comparison of Different Treatment Regimens In Patients With Nonalcoholic Fatty Liver Disease”. Experimental and Clinical Gastroenterology 17 (2015): 12-17.
  6. Singla N., et al. “Association of NAT2, GST and CYP2E 1 polymorphisms and anti-tuberculosis drug-induced hepatotoxicity”. Tuberculosis 94 (2014): 293-298.
  7. Getnet Yimer and Marcus Gry. “Evaluation of Patterns of Liver Toxicity in Patients on Antiretroviral and Anti-Tuberculosis Drugs: A Prospective Four Arm Observational Study in Ethiopian Patients (2014).
  8. Stockmann M., et al. “How to define initial poor graft function after liver transplantation? - a new functional definition by the LiMAx test”. Transplant International 23 (2010): 1023-1032.
  9. A Toure., et al. “Prevention of isoniazid toxicity by NAT2 genotyping in Senegalese tuberculosis patients”. Toxicology Reports 3 (2016): 826-831.
  10. Vidyasagar Ramappa and Guruprasad P Aithal. “Hepatotoxicity Related to Anti-tuberculosis Drugs: Mechanisms and Management”. Journal of Clinical and Experimental Hepatology 1 (2013): 37-49.
  11. Huang YS., et al. “Polymorphism of the N-acetyltransferase 2 gene as a susceptibility risk factor for antituberculosis drug-induced hepatitis”. Hepatology 35 (2002): 883-889.
Citation: Kliaritskaia IL and Shelikhova EO. “Drug Induced Liver Injury in HIV-Infected Patients during Antituberculosis Therapy”. EC Gastroenterology and Digestive System 7.10 (2020): 44-48.

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