Abstract
We evaluated in this cohort study the predictive ability of 23 peripheral blood parameters and ratios for treatment outcomes after the 2-month intensive phase in patients with PTB. In 63 patients out of 90 that turned culture negative, a significant decrease in white blood cell count, neutrophils, monocyte, hemoglobin, platelet, plateletcrit, erythrocyte sedimentation rate, MLR, NLR, PLR and SII values after anti-TB therapy compared to pretreatment was observed (p <0.001). Logistic regression analysis generated a model of predictors consisting of nine covariates. Spearman’s correlation analysis revealed significant positive correlations between NLR with NEU (r = 0.79, p<0.01), SII with NEU (r = 0.846, p<0.01), PLT with SII (r = 0.831, p<0.01), PLT with PCT (r = 0.71, p<0.01) and MPV with P-LCR (r = 0,897, p<0.01) in 63 patients out of 90 that turned culture negative after 2 months of treatment. ROC curve analysis indicated that all areas under the curve (AUC) revealed no statistically significant results, except lymphocyte for culture conversion. In summary, here we observed a set of hematological parameters that declined significantly as the disease was treated in patients that turned culture negative. Despite some limitations, our findings are useful for further studies aiming to identify hematological profiles that could predict the treatment outcome.
Highlights
Tuberculosis (TB), a chronic disease caused by Mycobacterium tuberculosis (Mtb), is the most common infectious disease today
We assessed if the values of HCT, mean corpuscular volume (MCV), red cell distribution width (RDW-CV), red cell distribution width (RDW-SD), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell (WBC), LYM, NEU, MON, PLT, PCT, platelet distribution width (PDW-CV), platelet distribution width (PDW-SD), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune-inflammation index (SII) and erythrocyte sedimentation rate (ESR) differ significantly when compared to the patients before treatment (T0) versus after the 2 month regimen treatment (T2)
The MLR, NLR, PLR and SII values were significantly lower when compared to the 63 patients that turned culture negative (T0 vs. T2) reaching the statistical significance (p
Summary
Tuberculosis (TB), a chronic disease caused by Mycobacterium tuberculosis (Mtb), is the most common infectious disease today. 10.0 million new cases occurred worldwide in 2018 and the annual death rate is 1.6 million [1, 2]. TB is one of the top causes of death, ranking it above HIV/AIDS [3]. Diagnosed TB cases across the globe are treated, according to the latest World Health Organization (WHO) guidelines, with a standard first-line treatment regimen (2HRZE/4HR) of four antibiotics, isoniazid (H), rifampicin (R), pyrazinamide (Z), and ethambutol (E)—consisting of a 2-month initial phase of (2RHZE), followed by a 4-month continuation phase (4RH) [9, 10]
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