GSTM1 and GSTT1 null polymorphisms and susceptibility to anti-tuberculosis drug-induced liver injury: a meta-analysis.

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.