Isoniazid-resistant tuberculosis: a cause for concern?
- 1 February 2017
- journal article
- review article
- Published by International Union Against Tuberculosis and Lung Disease in The International Journal of Tuberculosis and Lung Disease
- Vol. 21 (2), 129-139
- https://doi.org/10.5588/ijtld.16.0716
Abstract
The drug isoniazid (INH) is a key component of global tuberculosis (TB) control programmes. It is estimated, however, that 16.1% of TB disease cases in the former Soviet Union countries and 7.5% of cases outside of these settings have non-multidrug-resistant (MDR) INH resistance. Resistance has been linked to poorer treatment outcomes, post-treatment relapse and death, at least for specific sites of disease. Multiple genetic loci are associated with phenotypic resistance; however, the relationship between genotype and phenotype is complex, and restricts the use of rapid sequencing techniques as part of the diagnostic process to determine the most appropriate treatment regimens for patients. The burden of resistance also influences the usefulness of INH preventive therapy. Despite seven decades of INH use, our knowledge in key areas such as the epidemiology of resistant strains, their clinical consequences, whether tailored treatment regimens are required and the role of INH resistance in fuelling the MDR-TB epidemic is limited. The importance of non-MDR INH resistance needs to be re-evaluated both globally and by national TB control programmes.Keywords
This publication has 89 references indexed in Scilit:
- Bayesian Estimation of Mixture Models with Prespecified Elements to Compare Drug Resistance in Treatment-Naïve and Experienced Tuberculosis CasesPLoS Computational Biology, 2013
- Effect of Mutation and Genetic Background on Drug Resistance in Mycobacterium tuberculosisAntimicrobial Agents and Chemotherapy, 2012
- Drug resistance mutations and heteroresistance detected using the GenoType MTBDRplusassay and their implication for treatment outcomes in patients from Mumbai, IndiaBMC Infectious Diseases, 2012
- Treatment Outcomes of Isoniazid-Resistant Tuberculosis Patients, Western Cape Province, South AfricaClinical Infectious Diseases, 2011
- Short, Highly Effective, and Inexpensive Standardized Treatment of Multidrug-resistant TuberculosisAmerican Journal of Respiratory and Critical Care Medicine, 2010
- Selection of Mutations To Detect Multidrug-Resistant Mycobacterium tuberculosis Strains in Shanghai, ChinaAntimicrobial Agents and Chemotherapy, 2010
- Extensive transmission of isoniazid resistant M. tuberculosis and its association with increased multidrug-resistant TB in two rural counties of eastern China: A molecular epidemiological studyBMC Infectious Diseases, 2010
- Tuberculosis Drug Resistance Mutation DatabasePLoS Medicine, 2009
- Clinical Characteristics and Treatment Outcomes of Patients with Isoniazid‐Monoresistant TuberculosisClinical Infectious Diseases, 2009
- Population Genetics Study of Isoniazid Resistance Mutations and Evolution of Multidrug-Resistant Mycobacterium tuberculosisAntimicrobial Agents and Chemotherapy, 2006