Isoniazid-induced liver injury risk level in different variants of N-acetyltransferase 2 (NAT2) polymorphisms: A literature review

Individual NAT2 genotype identity data should be enriched to prevent Isoniazid-induced liver injury (IDILI) and optimize the dose of Isoniazid (INH). Therefore, this study aims to present the level of IDILI risk for specific genotype alleles. The data collection involves literature indexed by Google Scholar, Scopus, and Pubmed databases. The search uses a combination of the following keyword variants "INH" OR "INH", "liver injury" OR "hepatotoxicity", "polymorphism" OR "pharmacogenomic", and "N-acetyltransferase 2" OR "NAT2". Furthermore, the screening results of library sources were narrowed to 11 original articles that met the inclusion criteria. The IDILI risk assessment analysis due to NAT2 enzyme polymorphism following the odds ratio has a 95% confidence interval. The results showed that the IDILI risk level of the slow acetylator group was 3.11 times higher than other populations. Meanwhile, the rapid and intermediate acetylator groups were not at risk. Three variants related to *6 allele were classified as high risk; *6A/*6A risk 5.76 times, *6A/*7B (5.54 times), and *6/*7 ( 4 times). The three allele configurations of the *5 and *7 were also classified as a risk; *5B/*7B (5 times), *7B/*7B (3.23 times), and *5/*7 (2,74 times).