GSTM1 and GSTT1 null polymorphisms and susceptibility to anti-tuberculosis drug-induced liver injury: a meta-analysis [Review article]

BACKGROUND: Published data on the association between GSTM1 and GSTT1 polymorphisms and risk of anti-tuberculosis drug-induced liver injury (ATDILI) are inconclusive. OBJECTIVE: To derive a more precise estimation of the relationship, a meta-analysis on this topic was performed. DESIGN: PubMed, Medline, EMBASE and Chinese national knowledge infrastructure were searched for studies on the association of GSTM1 and GSTT1 polymorphisms with risk of ATDILI. Summary odds ratios (ORs) with their corresponding 95% confidence intervals (CIs) were calculated. RESULTS: The GSTM1 null genotype was associated with increased risk of ATDILI (OR(random-effects) 1.50, 95%CI 1.15-1.95). When stratifying for study population and median number of cases, statistically significant results were observed in the Chinese population (OR(random-effects) 1.45, 95%CI 1.12-1.92) and in studies with case numbers > 57 (OR(fixed-effects) 1.60, 95%CI 1.31-1.97). No statistically significant association was observed between GSTT1 null genotype or GSTM1/GSTT1 interaction and risk of ATDILI. CONCLUSION: The meta-analysis suggests that GSTM1 null genotype may be associated with an increased risk of ATDILI, particularly among the Chinese population. The GSTT1 null genotype or GSTM1/GSTT1 interaction may not affect susceptibility to ATDILI.