Poludenko H. Clinical pharmacological peculiarities of cytochrome-Р4503А4 during treatment of the patients with primary pulmonary tuberculosis

The dissertation is dedicated for revealing of the clinical pharmacological impact of cytochrome-P4503A4 peculiarities in patients with pulmonary tuberculosis (TB) for the effectiveness and safety of pharmacotherapy. It was established that TB patients with the *AG genotype according to the CYP3A4*1B locus have a higher risk of developing a subtherapeutic serum rifampicin concentration, a worse effectiveness of anti-tuberculosis therapy, and lower activity of ALT and AST than in patients with genotype *AA. In patients with pulmonary TB with *1G/1G genotype of CYP3A4*1G locus during anti-tuberculosis therapy, the activity of ALT and AST increased by 72.7% (P=0.033) and by 115.8% (P=0.049), respectively, while in *1/1 carriers the activity of ALT and AST almost did not change. It is recommended to determine the CYP3A4*1B and CYP3A4*1G genotypes in patients with pulmonary TB, which will allow to identify groups of the patients with higher risk of hepatotoxicity and lower treatment efficiency.