Given the strong association between slow NAT2 acetylator status and hepatotoxicity observed in our cohort (AOR = 78.18, 95% CI: 14.17-431.46), NAT2 genotyping should be considered for patients with clinical risk factors—such as advanced age, underweight BMI, or concomitant medication use—before TB treatment initiation. This evidence concerns the gene NAT2 and tuberculosis.