Association of baseline white blood cell counts with tuberculosis treatment outcome : a prospective multicentered cohort study

Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved..

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.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:100

Enthalten in:

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases - 100(2020) vom: 28. Nov., Seite 199-206

Sprache:

Englisch

Beteiligte Personen:

Chedid, Carole [VerfasserIn]
Kokhreidze, Eka [VerfasserIn]
Tukvadze, Nestani [VerfasserIn]
Banu, Sayera [VerfasserIn]
Uddin, Mohammad Khaja Mafij [VerfasserIn]
Biswas, Samanta [VerfasserIn]
Russomando, Graciela [VerfasserIn]
Acosta, Chyntia Carolina Díaz [VerfasserIn]
Arenas, Rossana [VerfasserIn]
Ranaivomanana, Paulo Pr [VerfasserIn]
Razafimahatratra, Crisca [VerfasserIn]
Herindrainy, Perlinot [VerfasserIn]
Rakotosamimanana, Niaina [VerfasserIn]
Hamze, Monzer [VerfasserIn]
Ismail, Mohamad Bachar [VerfasserIn]
Bayaa, Rim [VerfasserIn]
Berland, Jean-Luc [VerfasserIn]
Delogu, Giovanni [VerfasserIn]
Endtz, Hubert [VerfasserIn]
Ader, Florence [VerfasserIn]
Goletti, Delia [VerfasserIn]
Hoffmann, Jonathan [VerfasserIn]
HINTT working group within the GABRIEL network [VerfasserIn]

Links:

Volltext

Themen:

Immunomonitoring
Journal Article
Lymphopenia
Multi-drug resistance
Multicenter Study
Treatment monitoring
Tuberculosis
White blood cells

Anmerkungen:

Date Completed 08.02.2021

Date Revised 08.02.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.ijid.2020.09.017

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM314923179