Carole Chedid1, Eka Kokhreidze2, Nestani Tukvadze2, Sayera Banu3, Mohammad Khaja Mafij Uddin3, Samanta Biswas3, Graciela Russomando4, Chyntia Carolina Díaz Acosta4, Rossana Arenas5, Paulo Pr Ranaivomanana6, Crisca Razafimahatratra6, Perlinot Herindrainy6, Niaina Rakotosamimanana6, Monzer Hamze7, Mohamad Bachar Ismail7, Rim Bayaa7, Jean-Luc Berland8, Giovanni Delogu9, Hubert Endtz10, Florence Ader11, Delia Goletti12, Jonathan Hoffmann8. 1. Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, Lyon, France; Département de Biologie, Ecole Normale Supérieure de Lyon, Lyon, France. Electronic address: carole.chedid@fondation-merieux.org. 2. National Center for Tuberculosis and Lung Diseases (NCTBLD), Tbilisi, Georgia. 3. International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. 4. Instituto de Investigaciones en Ciencias de la Salud, National University of Asunción, Paraguay. 5. Hospital General de San Lorenzo, MSPyBS, Asunción, Paraguay. 6. Institut Pasteur de Madagascar, Antananarivo, Madagascar. 7. Laboratoire Microbiologie, Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon. 8. Laboratoire des Pathogènes Emergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, Lyon, France. 9. Università Cattolica del Sacro Cuore, Milan, Italy. 10. Fondation Mérieux, Lyon, France. 11. Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, France. 12. Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy.
Abstract
OBJECTIVES: Tuberculosis (TB) is the leading infectious cause of death in the world. Cheaper and more accessible TB treatment monitoring methods are needed. Here, we evaluated white blood cell (WBC) absolute counts, lymphocyte, and monocyte proportions during TB treatment, and characterized their association with treatment failure. METHODS: This multicentered prospective cohort study was based in Bangladesh, Georgia, Lebanon, Madagascar, and Paraguay. Adult, non-immunocompromised patients with culture-confirmed pulmonary TB were included and followed up after two months of treatment and at the end of therapy. Blood counts were compared to treatment outcome using descriptive statistics, logistic regression, and Receiver Operating Characteristic (ROC) analyses. RESULTS: Between December 2017 and August 2020, 198 participants were enrolled, and 152 completed treatment, including 28 (18.5%) drug-resistant patients. The rate of cure at the end of treatment was 90.8% (138/152). WBC absolute counts decreased, and lymphocyte proportions increased throughout treatment. In multivariate analyses, baseline high WBC counts and low lymphocyte proportions were associated with positive sputum culture results at the end of treatment (WBC > 11,450 cells/mm3: p = 0.048; lymphocytes <16.0%: p = 0.039; WBC > 11,450 cells/mm3 and lymphocytes <16.0%: p = 0.024). CONCLUSION: High WBC counts and low lymphocyte proportions at baseline are significantly associated with the risk of TB treatment failure.
OBJECTIVES:Tuberculosis (TB) is the leading infectious cause of death in the world. Cheaper and more accessible TB treatment monitoring methods are needed. Here, we evaluated white blood cell (WBC) absolute counts, lymphocyte, and monocyte proportions during TB treatment, and characterized their association with treatment failure. METHODS: This multicentered prospective cohort study was based in Bangladesh, Georgia, Lebanon, Madagascar, and Paraguay. Adult, non-immunocompromised patients with culture-confirmed pulmonary TB were included and followed up after two months of treatment and at the end of therapy. Blood counts were compared to treatment outcome using descriptive statistics, logistic regression, and Receiver Operating Characteristic (ROC) analyses. RESULTS: Between December 2017 and August 2020, 198 participants were enrolled, and 152 completed treatment, including 28 (18.5%) drug-resistant patients. The rate of cure at the end of treatment was 90.8% (138/152). WBC absolute counts decreased, and lymphocyte proportions increased throughout treatment. In multivariate analyses, baseline high WBC counts and low lymphocyte proportions were associated with positive sputum culture results at the end of treatment (WBC > 11,450 cells/mm3: p = 0.048; lymphocytes <16.0%: p = 0.039; WBC > 11,450 cells/mm3 and lymphocytes <16.0%: p = 0.024). CONCLUSION: High WBC counts and low lymphocyte proportions at baseline are significantly associated with the risk of TB treatment failure.
Authors: Karen Cilliers; Angela Menezes; Tariq Webber; Hazel M Dockrell; Jacqueline M Cliff; Léanie Kleynhans; Novel N Chegou; Nelita du Plessis; André G Loxton; Martin Kidd; Joel Fleury Djoba Siawaya; Katharina Ronacher; Gerhard Walzl Journal: Tuberculosis (Edinb) Date: 2021-04-10 Impact factor: 3.131
Authors: Marco P La Manna; Valentina Orlando; Giusto D Badami; Bartolo Tamburini; Mojtaba Shekarkar Azgomi; Elena Lo Presti; Franca Del Nonno; Linda Petrone; Beatrice Belmonte; Laura Falasca; Paola Di Carlo; Francesco Dieli; Delia Goletti; Nadia Caccamo Journal: Eur J Immunol Date: 2022-04-09 Impact factor: 6.688