Resolution of the acute-phase response in West African patients receiving treatment for pulmonary tuberculosis.
METHODS
The Komfo Anokye Teaching Hospital, Kumasi, Ghana, West Africa.


OBJECTIVE
To evaluate simple and commonly used parameters of the acute-phase response as correlates of successful resolution of smear-positive pulmonary tuberculosis (PTB) during drug treatment.


METHODS
Serum C-reactive protein (CRP) concentration, erythrocyte sedimentation rate (ESR), body weight, and blood haemoglobin were measured in human immunodeficiency virus (HIV) negative Ghanaian patients with PTB (n = 15) and in age- and sex-matched healthy controls (n = 15). These parameters were subsequently measured in patients after 1, 2 and 3 months of antituberculosis treatment. Serum concentrations of soluble interleukin-2-receptor-alpha (sCD25) were also measured as a comparative index of resolution of the systemic inflammatory process.


RESULTS
Anti-tuberculosis treatment resulted in sputum smear conversion in all 15 patients. After one month of treatment, reductions in serum CRP concentration (>20%) and increases in haemoglobin concentration (>0.4 g/dl) occurred in the majority of patients and correlated with steep reductions in serum levels of sCD25. In contrast, weight loss and elevated ESR were slower to resolve, and were insensitive early markers of response to treatment.


CONCLUSIONS
A fall in serum CRP and a rise in blood haemoglobin are correlates of the initial response to drug treatment of PTB. These parameters may assist in the evaluation of empiric trials of treatment in microbiologically unconfirmed cases of suspected PTB.
Lawn
S D
SD
Department of Infectious Diseases, St. George's Hospital Medical School, London, UK. sil3@cdc.gov
Obeng
J
J
Acheampong
J W
JW
Griffin
G E
GE
D000210:Acute-Phase Reaction / Q000097:blood / Q000209:etiology* / Q000276:immunology*; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D001835:Body Weight; D002097:C-Reactive Protein / Q000187:drug effects* / Q000378:metabolism*; D016022:Case-Control Studies; D016903:Drug Monitoring; D005260:Female; D005869:Ghana; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D015375:Receptors, Interleukin-2 / Q000097:blood*; D015203:Reproducibility of Results; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy* / Q000276:immunology* / Q000382:microbiology
D000995:Antitubercular Agents; D015415:Biomarkers; D006454:Hemoglobins; D015375:Receptors, Interleukin-2; D002097:C-Reactive Protein