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Characteristics and Treatment Outcomes of Isoniazid Mono-Resistant Tuberculosis: A Retrospective Study

 Se Hyun Kwak  ;  Ji Soo Choi  ;  Eun Hye Lee  ;  Su Hwan Lee  ;  Ah Young Leem  ;  Sang Hoon Lee  ;  Song Yee Kim  ;  Kyung Soo Chung  ;  Eun Young Kim  ;  Ji Ye Jung  ;  Moo Suk Park  ;  Young Sam Kim  ;  Joon Chang  ;  Young Ae Kang 
 YONSEI MEDICAL JOURNAL, Vol.61(12) : 1034-1041, 2020-12 
Journal Title
Issue Date
Adult ; Aged ; Antitubercular Agents / pharmacology ; Antitubercular Agents / therapeutic use* ; Female ; Humans ; Isoniazid / pharmacology ; Isoniazid / therapeutic use* ; Male ; Middle Aged ; Mutation ; Mycobacterium tuberculosis / drug effects ; Mycobacterium tuberculosis / genetics ; Mycobacterium tuberculosis / isolation & purification* ; Prevalence ; Republic of Korea / epidemiology ; Retrospective Studies ; Treatment Outcome ; Tuberculosis / drug therapy ; Tuberculosis, Multidrug-Resistant / drug therapy*
Tuberculosis ; isoniazid ; treatment outcome
Purpose: Isoniazid (INH) mono-resistant tuberculosis (Hr-TB) is a highly prevalent type of drug-resistant TB, possibly associated with unfavorable treatment outcomes. However, definitive guidelines on an optimal treatment regimen and duration for Hr-TB are currently under discussion. We evaluated the characteristics and treatment outcomes of Hr-TB patients.

Materials and methods: We retrospectively reviewed the medical records of Hr-TB patients treated at a South Korean tertiary referral hospital from January 2005 to December 2018.

Results: We included 195 Hr-TB patients. 113 (57.9%) were male, and the median age was 56.6 [interquartile range, 40.2-68.6] years. Mutations in katG were the most frequent [54 (56.3%)], followed by those in the inhA [34 (35.4%)]. Favorable and unfavorable outcomes were noted in 164 (84.1%) and 31 (15.9%) patients, respectively. Smoking history [odds ratio (OR)=5.606, 95% confidence interval (CI): 1.695-18.543, p=0.005], low albumin level (OR=0.246, 95% CI: 0.104-0.578, p=0.001), and positive acid-fast bacilli culture at 2 months (OR=7.853, 95% CI: 1.246-49.506, p=0.028) were associated with unfavorable outcomes.

Conclusion: A tailored strategy targeting high-risk patients is imperative for improved treatment outcomes. Further research on the rapid and accurate detection of resistance to INH and other companion drugs is warranted.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Kwak, Se Hyun(곽세현)
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Eun Young(김은영) ORCID logo https://orcid.org/0000-0002-3281-5744
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Lee, Sang Hoon(이상훈) ORCID logo https://orcid.org/0000-0002-7706-5318
Lee, Su Hwan(이수환) ORCID logo https://orcid.org/0000-0002-3487-2574
Lee, Eun Hye(이은혜) ORCID logo https://orcid.org/0000-0003-2570-3442
Leem, Ah Young(임아영) ORCID logo https://orcid.org/0000-0001-5165-3704
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jung, Kyung Soo(정경수) ORCID logo https://orcid.org/0000-0003-1604-8730
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
Choi, Ji Soo(최지수) ORCID logo https://orcid.org/0000-0003-2716-6775
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