Isoniazid/acetylisoniazid urine concentrations: markers of adherence to isoniazid preventive therapy in children

Int J Tuberc Lung Dis. 2014 May;18(5):528-30. doi: 10.5588/ijtld.13.0730.

Abstract

The Arkansas colorimetric method monitors adherence to isoniazid (INH) by the detection of INH metabolites in urine. Urine samples 4 h after INH administration in 31 human immunodeficiency virus infected children receiving daily or thrice weekly INH preventive therapy were Arkansas test-positive for 29/31 (94%), while acetylisoniazid (AcINH) was detected in 30/31 (97%) using mass spectrometry. At 24, 48 and 72 h, only 78%, 23% and 0 samples, respectively, were Arkansas-positive, while INH or AcINH was detected in respectively 94%, 69% and 33%. The Arkansas test reliably predicted INH ingestion at a clinic visit 4 h after morning doses, but did not perform well at 24 h.

Trial registration: ClinicalTrials.gov NCT00330304.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / pharmacokinetics
  • Antitubercular Agents / urine*
  • Biomarkers / urine
  • Biotransformation
  • Child
  • Chromatography, High Pressure Liquid
  • Coinfection*
  • Colorimetry
  • Drug Monitoring / methods*
  • HIV Infections / complications*
  • HIV Infections / diagnosis
  • Humans
  • Isoniazid / administration & dosage
  • Isoniazid / analogs & derivatives*
  • Isoniazid / pharmacokinetics
  • Isoniazid / urine
  • Medication Adherence*
  • Predictive Value of Tests
  • Primary Prevention / methods*
  • Reproducibility of Results
  • South Africa
  • Tandem Mass Spectrometry
  • Tuberculosis / complications
  • Tuberculosis / diagnosis
  • Tuberculosis / prevention & control*

Substances

  • Antitubercular Agents
  • Biomarkers
  • acetylisoniazid
  • Isoniazid

Associated data

  • ClinicalTrials.gov/NCT00330304