Abstract
The study was done to determine the levels of interferon-gamma, interleukin 6, interleukin 10, iron status, hepcidin and haematological parameters of patients with pulmonary tuberculosis co-infected with human immunodeficiency virus in Southeast, Nigeria. This study was carried out at the directly observed treatment-short course Tuberculosis (TB DOTS) centre of Federal Medical Centre, Umuahia, located in South-Eastern Nigeria. Therefore, sample size of 240 was used to give room for attrition. A total of two hundred and forty (240) subjects aged 18-60 years were enlisted for this study. Seven milliliters (7ml) of venous blood was collected from each subject and 2.5 ml was dispensed into bottles containing di-potassium salt of ethylenediamine tetra-acetic acid (K2-EDTA) and was used for full blood count, CD4 count and HIV screening. Also, 4.5ml was dispensed into plain tubes. Serum was obtained after clotting by spinning at 3000 RPM for 10 minutes and was used for interferon gamma, interleukin-6, and interleukin-10, iron and hepcidin determination. Data was analysed using statistical package for social science (SPSS) version 20. Student t-test, ANOVA (Analysis of Variance), Pearson Product Moment and Chi-Square were the tools employed. Results were expressed as mean ± standard deviation and are presented in table and significance level was set at P<0.05.The results showed difference that was statistically significant (P<0.05) in IFN-γ (P=0.000), IL-6 (P=0.000) IL-10 (P=0.000), CD4 (P=0.000), hepcidin (P=0.000), Iron (P=0.000), TIBC (P=0.000), %TSA (P=0.001) ,WBC (P=0.000), Neutrophils (P=0.000), Lymphocyes (P=0.000), Monocytes (P=0.000), Eosinophils (P=0.000), Basophils (P=0.018), RBC (P=0.000), haemoglobin (P=0.000), PCV (P=0.000), MCV (P=0.000), MCH (P=0.000), MCHC (P=0.000), Platelets (P=0.000), ESR (P=0.000) when compared among control, TB, HIV and TB-HIV subjects respectively. The co infection of HIV on pulmonary TB patients increases the levels of the cytokines. The cytokines and hepcidin can be used as adjunct to prognostic and diagnostic markers as their levels decreased with increased duration of treatment of the patients. The study has shown wide variations in the haemtological indices studied.
Highlights
Pulmonary tuberculosis (TB) is a recurring bacterial illness triggered by Mycobacterium tuberculosis (MTB) complex which frequently affects the lungs; (pulmonary TB (PTB), but can affect other parts as well; (extrapulmonary TB (EPTB) as opined by Thumamo et al [1,2]
The study was done to determine the levels of interferon-gamma, interleukin 6, interleukin 10, iron status, hepcidin and haematological parameters of patients with pulmonary tuberculosis co-infected with human immunodeficiency virus in Southeastern part of Nigeria
Since hepcidin has a well described, central role in anaemia of chronic diseas (ACD) as opined by Weiss and Goodnough [44], in which its expression is upregulated predominantly by Interleukin 6 (IL-6) in response to infections such as tuberculosis [42], these results provide further evidence to suggest that ACD is the predominant mechanism underlying anemia in patients with tuberculosis-associated Human Immunodeficiency virus (HIV) [49]
Summary
Pulmonary tuberculosis (TB) is a recurring bacterial illness triggered by Mycobacterium tuberculosis (MTB) complex which frequently affects the lungs; (pulmonary TB (PTB), but can affect other parts as well; (extrapulmonary TB (EPTB) as opined by Thumamo et al [1,2]. Mycobacterium tuberculosis, the bacterium that leads to human pulmonary tuberculosis illness, is an ancient foe. Chronologically; pulmonary tuberculosis (PTB) has a pedigree that could be linked to the earliest origin of humans having been in life as 150,000-200,000 years ago [3]. Mycobacterium tuberculosis is an acid fast facultative intracellular rod shaped bacterium. It is non- motile, obligate aerobe with extended generation period and favours especially to localize in macrophages [4,5]
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