Isoniazid/acetylisoniazid urine concentrations: markers of adherence to isoniazid preventive therapy in children
Amlabu, V.; Mulligan, C.; Jele, N.; Evans, A.; Gray, D.; Zar, H.J.; McIlleron, H.; Smith, P.
International Journal of Tuberculosis and Lung Disease the Official Journal of the International Union Against Tuberculosis and Lung Disease 18(5): 528-530
2014
ISSN/ISBN: 1027-3719 PMID: 24903787 DOI: 10.5588/ijtld.13.0730Document Number: 636248
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.