Association Between the NAT2 Gene and Pyrazinamide-induced Liver Injury in Peruvian Patients with Tuberculosis

Oscanoa T.J.; Guevara-Fujita M.L.; Acosta O.; Moscol S.; Fujita R.M. · Revista del Cuerpo Medico Hospital Nacional Almanzor Aguinaga Asenjo (2026) · DOI: 10.35434/rcmhnaaa.2026.191.2833

Resumen

Introduction: The N-acetyltransferase 2 (NAT2) gene has been widely studied for its association with drug-induced liver injury (DILI) caused by antituberculosis drugs. This study aimed to examine the association between six polymorphisms of the NAT2 gene and pyrazinamide-induced liver injury (PILI) in Peruvian patients. Materials and methods: Specific association with PILI was determined through processes such as rechallenge, suspension, and recovery. Six NAT2 gene polymorphisms were studied: rs1799929 (c.481C>T), rs1799930 (c.590G>A), rs1799931 (c.857G>A), rs1041983 (c.282C>T), rs1801280 (c.341T>C), and rs1208 (c.802G>A). Results: Forty patients (ten cases and thirty controls) with tuberculosis were included in the study. For the rs1041983 polymorphism (c.282C>T), the odds ratio (OR) was 3.7 (95% CI: 1.3–10.6) when analyzed as C vs. T, indicating an association and risk of PILI with the T allele. Additionally, for the rs1208 (c.802G>A) polymorphism, the OR was, and 3.2 (95% CI: 1.0–10.0) for A vs. G, indicating an association and risk of PILI with the A allele. No significant associations were found with the other NAT2 polymorphisms studied. Conclusions: The evaluation of six NAT2 gene polymorphisms indicates a probable association between rs1041983 (c.282C>T) and rs1208 (c.802G>A) and PILI in Peruvian patients with tuberculosis.

Instituciones: Universidad Nacional Mayor de San Marcos; Universidad de San Martín de Porres