Isoniazid hair drug levels among TB patients as a tool to monitor adherence, exposure, and TB treatment outcomes and its acceptability in a multicultural setting. A narrative review

Afr Health Sci. 2023 Dec;23(4):28-34. doi: 10.4314/ahs.v23i4.5.

Abstract

Background: Accumulation of chemicals including drugs in hair has been used in forensic investigations. Studies have reported isoniazid drug levels in the hair of TB patients.

Objective: To review literature for evidence on isoniazid hair drug levels as a tool to monitor adherence, exposure, and TB treatment outcomes and the acceptability of using human hair for medical testing.

Methods: We reviewed literature through Pubmed, Embase, Medline, google scholar, and google grey literature. The search terms focused on isoniazid/TB hair drug levels, adherence, treatment outcomes, and acceptability of using hair for medical testing. We kept refining our search terms at each step of our search.

Results: The initial search yielded 186859 articles, which dropped to 88 after removing duplicates and irrelevant articles and eventually to 14 on further refining our search terms. On full review,2 out of 14 and 1 out of 14 articles touched the area of Isoniazid hair drug levels; adherence, exposure, TB treatment outcomes, and acceptability respectively. Further scrutiny showed that none of the articles had addressed our research question.

Conclusion: Literature on Isoniazid hair drug levels among TB patients as a tool to monitor adherence, exposure, and TB treatment outcomes, and its acceptability is limited and more research is needed.

Keywords: TB patients; TB treatment outcomes; adherence; multicultural setting; narrative review.

Publication types

  • Review

MeSH terms

  • Antitubercular Agents* / pharmacokinetics
  • Antitubercular Agents* / therapeutic use
  • Hair* / chemistry
  • Humans
  • Isoniazid* / pharmacokinetics
  • Isoniazid* / therapeutic use
  • Medication Adherence / statistics & numerical data
  • Treatment Outcome
  • Tuberculosis* / drug therapy

Substances

  • Isoniazid
  • Antitubercular Agents