Pyridoxal-5-phosphate plasma concentrations in children receiving tuberculosis chemotherapy including isoniazid
Date
2010
Authors
Cilliers K.
Labadarios D.
Schaaf H.S.
Willemse M.
Maritz J.S.
Werely C.J.
Hussey G.
Donald P.R.
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Abstract
Aim: Little is known about pyridoxine nutriture of children treated with isoniazid (INH) regimens. This study documents plasma pyridoxal 5′-phosphate (PLP) concentrations in children, HIV-infected and HIV-uninfected, receiving INH regimens. Methods: Children from the Western Cape of South Africa hospitalized for tuberculosis (TB) management were studied. Plasma PLP concentrations were determined on enrolment, 1-month after commencing TB treatment, and again after 4-month's treatment. The children received a supplement meeting pyridoxine requirements. Results: Nineteen HIV-infected and 33 HIV-uninfected children received INH (dosage range 4-20 mg/kg) daily. Mean PLP plasma concentrations on enrolment were 8.32 (SD 6.75) ng/mL and 11.28 (SD 3.02) ng/mL in HIV-infected and HIV-uninfected children, respectively (p = 0.11) and after 4-month's treatment 6.75 (SD 2.71) ng/mL and 14.76 (SD 7.96) ng/mL (p < 0.001). On enrolment 9 (50%) HIV-infected and 5 (15%) HIV-uninfected children (p = 0.016) had suboptimal PLP concentrations (<6 ng/mL); after 4-month's treatment 8 (42%) and 2 (6%) (p = 0.004). Conclusion: Plasma PLP concentrations in children treated for TB were low on enrolment in HIV-infected and HIV-uninfected children; after 4-month's treatment low values were still common in HIV-infected children. Additional pyridoxine supplementation of malnourished children treated for tuberculosis is advisable, particularly those HIV-infected. © 2010 Foundation Acta Pædiatrica.
Description
Keywords
acyltransferase, efavirenz, ethambutol, ethionamide, isoniazid, isoniazid plus rifampicin, pyrazinamide, pyridoxal 5 phosphate, pyridoxine, rifampicin, rifater, rimcure, ritonavir, unclassified drug, adolescent, article, child, childhood disease, controlled study, female, human, Human immunodeficiency virus infection, infant, lung tuberculosis, major clinical study, male, malnutrition, Mycobacterium tuberculosis, outcome assessment, patient assessment, preschool child, priority journal, school child, South Africa, tuberculous meningitis, vitamin blood level, vitamin supplementation, Adolescent, AIDS-Related Opportunistic Infections, Antitubercular Agents, Child, Child, Preschool, Female, Genotype, HIV Infections, Humans, Infant, Isoniazid, Male, Pyridoxal Phosphate, South Africa, Tuberculosis
Citation
Acta Paediatrica, International Journal of Paediatrics
99
5
99
5