Kinetics of sedimentation rate, viral load and TNF-alpha in relation to HIV co-infection in tuberculosis.
The kinetics of potential surrogate markers in HIV-positive (HIV+) and HIV-negative (HIV-), smear-positive tuberculosis (Tb+) patients in Gondar, Ethiopia (n = 60) was investigated. Clinical symptoms, sputum conversion, sedimentation rate (SR), HIV viral load and serum levels of TNF-alpha were determined before and 8 weeks after treatment initiation. The co-infection rate of HIV was 45%. There were significantly higher initial levels of SR and TNF-alpha in HIV+/Tb+ patients (79 +/- 29 mm/h and 13.5 +/- 7.6 pg/ml), than in HIV-/Tb+ patients (60 +/- 23 mm/h and 6.8 +/- 5.9 pg/ml, P<0.001). In HIV-/Tb+ patients, there was a marked decrease in SR compared with co-infected patients (46% [33 +/- 24 mm/h at week 8] vs. 24% [61 +/- 27 mm/h at week 8]). The HIV viral load (4.99 [range 3.70-5.92] to 4.90 [range 3.96-5.78] log10 copies/ml from week 0 to 8) and TNF-alpha (13.5 +/- 7.6 to 12.0 +/- 6.0 pg/ml) remained high in HIV+/Tb+ patients. In Tb patients, SR was significantly increased in HIV+ compared with HIV- patients. Additionally, TNF-alpha and HIV viral load remained elevated in HIV+/Tb+ patients following treatment despite clinical improvement comparable to HIV-/Tb+ patients.
Schön
Thomas
T
Department of Medical Microbiology, Faculty of Health Sciences, Linköping University, Linköping, Sweden. thomassc@ltkalmar.se
Wolday
Dawit
D
Elias
Daniel
D
Melese
Endalkachew
E
Moges
Feleke
F
Tessema
Tesfaye
T
Stendahl
Olle
O
Sundqvist
Tommy
T
Britton
Sven
S
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000995:Antitubercular Agents / Q000627:therapeutic use; D001799:Blood Sedimentation; D019353:Endemic Diseases; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000188:drug therapy / Q000821:virology*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*; D019562:Viral Load
D000995:Antitubercular Agents; D014409:Tumor Necrosis Factor-alpha