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This study aims to investigate whether genetic variants in the N\u2010acetyltransferase 2 gene (\n                      <jats:italic>NAT2<\/jats:italic>\n                      ) and the HLA\u2010DOA gene (\n                      <jats:italic>HLA\u2010DOA)<\/jats:italic>\n                      are associated with ATDILI susceptibility and clinical manifestations in a Western Chinese population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 1358 participants with active tuberculosis were enrolled and genotyped for four\n                      <jats:italic>NAT2<\/jats:italic>\n                      polymorphisms and five\n                      <jats:italic>HLA\u2010DOA<\/jats:italic>\n                      loci. Associations between candidate genetic variants and ATDILI were evaluated using logistic regression analyses, with multiple comparisons adjusted by Bonferroni correction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall incidence of ATDILI was 28.4% (385\/1358) in this cohort. Under a recessive model,\n                      <jats:italic>NAT2<\/jats:italic>\n                      rs1799930 was found to increase the risk of ATDILI (odds ratio [OR]\u2009=\u20091.88, 95% confidence interval [CI]: 1.20\u20132.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), which remained significant after Bonferroni correction (adjusted\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). Meanwhile, while\n                      <jats:italic>HLA\u2010DOA<\/jats:italic>\n                      rs1367731 (OR\u2009=\u20090.41, 95% CI: 0.18\u20130.93,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033), rs6913008 (OR\u2009=\u20090.39, 95% CI: 0.17\u20130.89,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024), and rs9276975 (OR\u2009=\u20090.47, 95% CI: 0.23\u20130.98,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045) demonstrated a promising protective genomic characteristic that may mitigate the development of ATDILI. However, none of the reported\n                      <jats:italic>HLA\u2010DOA<\/jats:italic>\n                      associations remained statistically significant after applying Bonferroni corrections. Regarding clinical manifestations,\n                      <jats:italic>NAT2<\/jats:italic>\n                      rs1799930 and rs1799931 have been linked to poor ATDILI clinical presentations, whereas certain\n                      <jats:italic>HLA\u2010DOA<\/jats:italic>\n                      variants (rs1367731, rs6913008, and rs9276975) were possibly linked to milder ATDILI severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Our findings preliminarily suggest that the\n                      <jats:italic>NAT2<\/jats:italic>\n                      and\n                      <jats:italic>HLA\u2010DOA<\/jats:italic>\n                      genetic variants may play a role in ATDILI susceptibility and clinical outcomes.\n                      <jats:italic>NAT2<\/jats:italic>\n                      rs1799930 represents a potential genetic risk marker, while\n                      <jats:italic>HLA\u2010DOA<\/jats:italic>\n                      variants may serve as protective factors warranting further validation. These findings may contribute to the precision management of ATDILI and the prevention of anti\u2010TB drug\u2010associated liver injury.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iid3.70517","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:09:55Z","timestamp":1789495795000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Genetic Variants at the\n                    <i>NAT2<\/i>\n                    and\n                    <i>HLA\u2010DOA<\/i>\n                    are Associated With Anti\u2010Tuberculosis Drug\u2010Induced Liver Injury Susceptibility and Clinical Manifestations in Western Chinese Populations"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0644-0205","authenticated-orcid":false,"given":"Zhenzhen","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Laboratory 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