The Association of Glutathion Peroxydase-1 Serum and Sensorineural Hearing Lossin MDR TB Patients with Kanamycin Therapy

Introduction: Kanamycin therapy in Multi-Drug Resistance Tuberculosis (MDR-TB) patients increases the possibility of sensorineural hearing loss through increasing the level of Reactive Oxygen Species (ROS) production in cochlea, particularly in hair cells. In normal state, ROS is detoxicated by numerous antioxidant enzymes, including glutathione peroksidase-1 (GPx-1). Imbalance of antioxidant enzymes and ROS production leads to death of hair cells and eventually sensorineural hearing loss. Objective: This study aimed to observe the association of GPx-1 level and sensorineural hearing loss in MDR-TB patients with Kanamycin therapy.

Method: This study was a prospective observational study conducted at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, between February to April 2017. 17 patients were included into the study with pre- and post-kanamycin therapy examination within 3 weeks duration using pure tone audiometry and serum level of GPx-1. Statistic analysis was done using Mann Whitney test with significant level of p < 0.05.

Result: A significant reduction of GPx-1 level in 3 weeks period after the initial Kanamycin administration was found in the study; p <0.001. Furthermore, there was a significant alteration in the hearing threshold on frequency of 500-800 Hz after Kanamycin administration; p < 0.05. There was a significant association between GPx-1 level and sensorineural hearing loss in Kanamycin therapy; p < 0.05.

Conclusion: Sensorineural hearing loss in patient with history of Kanamycin therapy was associated with level of GPx-1 degradation.