SLCO1B1, NAT2 Polymorphisms and Pharmacokinetic Variability of Rifampicin and Isoniazid in Tuberculosis Patients from Sub-Saharan Africa

SLCO1B1 and NAT2 polymorphisms have been associated with the variability of Rifampicin and Isoniazid pharmacokinetic (PK). The objective of this study was to identify in African patients with tuberculosis (TB) or TB/HIV co-infection, the SLCO1B1 and NAT2 polymorphisms, associated with the variability of Rifampicin and Isoniazid pharmacokinetic. TB or TB/HIV co-infected patients from Benin, Guinea, Senegal, and South Africa were included in this study. The blood samples collected were stored at -80&#730C until DNA extractions. The DNA extracts were then frozen at -80&#730C after quality control. Double stranded DNA of the samples were quantified using a fluorimetric method to select suitable samples for the preparation of 96-well microplates, containing 100 μl of DNA extract per well at the concentration of 20 ng/μl. Illumina HumanOmniExpress-24 v1.2 microarray genotyping was performed by an external vendor. The genotyping data were analyzed and the polymorphisms with a call rate < 95% or presenting a departure from the Hardy-Weinberg Equilibrium (HWE) were excluded. The correlation between significant genetic polymorphisms, the clearance, and the AUC were tested by a multiple linear regression model using the PLINK2 software. Out of 385 samples, five (05) were excluded after quality controls. After the frequency test, 384,586 SNPs failed the Hardy-Weinberg Equilibrium. Finally, 378 samples and 318,751 SNPs were included in the genetic analyses. The SLCO1B1 and NAT2 polymorphisms were associated with the variability of Rifampicin and Isoniazid PK parameters. There are SLCO1B1 and NAT2 polymorphisms carriers among TB and TB/HIV co-infected patients from Sub-Saharan Africa.

Diagnosis and Treatment Outcomes of Tuberculosis in Relation to Gender and HIV STATUS in South Benin

Background: In Benin, little is known about the influence of both gender and HIV-status on diagnostic patterns and treatment outcomes of Tuber-culosis (TB) patients. Objective: To assess whether differences in gender and HIV status affect diagnostic patterns and treatment outcomes of TB patients. Methods: Retrospective cohort study of patients registered in 2013 and 2014 in the three largest TB Basic Management Units in south Benin. Results: Of 2694 registered TB patients, 1700 (63.1%) were male. Case notification rates were higher in males compared with females (96 vs 53/100,000 inhabitants). The male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV negative cases. In HIV-positive patients, there were no differences in TB types between men and women. In HIV-negative patients, there were significantly higher proportions of females with clinically diagnosed pulmonary TB (p = 0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times higher amongst males compared with females. For New bacteriologically confirmed pulmonary TB, no differences were observed in treatment outcomes between genders in the HIV positive group;but significantly more unfavorable outcomes were reported among HIV negative males, with higher rates of failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study has shown that overall TB notification rates were higher in males than in females in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.