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Isoniazid resistant tuberculosis: a cause for concern?

Stagg, HR; Lipman, MC; McHugh, T; Jenkins, HE; (2017) Isoniazid resistant tuberculosis: a cause for concern? International Journal of Tuberculosis and Lung Disease , 21 (2) pp. 129-139. 10.5588/ijtld.16.0716. Green open access

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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 former Soviet Union countries and 7.5% of cases outside of those 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, but the relationship between genotype and phenotype is complex. This 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 preventative therapy. Despite seven decades of the use of INH 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.

Type: Article
Title: Isoniazid resistant tuberculosis: a cause for concern?
Open access status: An open access version is available from UCL Discovery
DOI: 10.5588/ijtld.16.0716
Publisher version: https://doi.org/10.5588/ijtld.16.0716
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions
Keywords: epidemiology; monoresistance; public health
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1522520
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