Effect of physiological characteristics, smoking, and alcohol use on isoniazid hair drug levels among pulmonary TB patients: a cross-sectional study at one month of intensive TB treatment.

BACKGROUND

Tuberculosis(TB) is still among the leading causes of death from a single infectious pathogen worldwide. TB treatment is long, requires multiple drug combinations, and therefore adherence monitoring. TB hair drug levels have been suggested as a technique of treatment adherence monitoring; however, the drug levels might be affected by physiological factors, alcohol use, and cigarette smoking. This can affect the pharmacokinetics and pharmacodynamics of TB drugs.

OBJECTIVE

To assess the effect of physiological factors, smoking, and alcohol on isoniazid hair drug levels during TB treatment.

METHODS

Patients were assessed for diabetes Mellitus, smoking, alcohol consumption, age, weight, and gender. Hair drug levels were measured by Liquid Chromatography Mass Spectrometry(LC-MS).

RESULTS

We screened a total of 102 TB patients and enrolled 56 participants out of which 50 completed the study. We excluded 15 participants who were not sampled exactly at 1-month appointment dates and of the remaining 35; the mean hair drug level was 0.0706ng/mg, 95% CI: 0.0303-0.1109. Tests of interaction across the different subgroups yielded no statistically significant interaction coefficients(IC) except for age and gender (IC=-0.36.95%, CI: -0.55-0.17, P=0.001).

CONCLUSION

Physiological factors, alcohol, and smoking do not affect isoniazid hair drug levels.