Hepatic Injury and Glutathione s-transferase Deletion Related to Antituberculosis Use: An Observational Study in Balinese Population, Indonesia

BACKGROUND: Glutathione S-transferase (GST), together with other drug-metabolizing enzymes (N-acetyltransferase and cytochrome P450), plays a crucial role in the metabolism of isoniazid (isonicotinic acid hydrazide). Among five isoforms of GST, GSTM1, and GSTT1 had been proved to involve in isoniazid metabolism. AIM: We aimed to investigate association between GST deletion and hepatic injury in the Indonesian population. METHODS: This is a cross-sectional study. The total participants’ number was 70. Our whole blood samples were collected from adult pulmonary tuberculosis patients who received antituberculosis treatment category one in Bali. Detection for GSTM1 and GSTT1 deletion performed with the polymerase chain reaction technique using internal standard β-globin. Data analysis performed with the Chi-square test. RESULTS: The proportion of GSTM1 null was 71.4% whereas the GSTT1 null was 34.3%. The proportion of combined GSTM1 null and GSTT1 null was 22.9%. There was no significant difference in liver damage incidence between GSTM1 null and wild-type (p > 0.005). There was also no significant difference in liver damage incidence between GSTT1 null and wild-type (p > 0.005). CONCLUSIONS: Neither GSTM1 nor GSTT1 deletion proved to be associated with liver injury regarding antituberculosis use.