Lipids As Indirect Biomarkers Of Pulmonary Tuberculosis In Patients With And Without Hiv Infection In Addis Ababa Ethiopia

Background: - Even though some studies have shown that lipids could be indirect markers ofrnpulmonary tuberculosis (TB), there is no sufficient data from Ethiopia which characterize the level ofrnthese markers during TB disease and infection. Nonetheless, the effect of HIV co-infection and itsrntreatment on the level of these makers is not well investigated.rnObjective: - to determine whether lipids are indirect biomarkers of pulmonary TB in pts with or withrnout HIV infection.rnMethods: - fasting plasma samples collected from 159 untreated adults visiting various healthrninstitutions in Addis Ababa (44 HIV+/TB+, 49 HIV-/TB+, 17 HIV+/TST+, 24 HIV-/TST+ and 25rnHIV-/TST-) at baseline, from 88 (30 HIV+/TB+, 47 HIV-/TB+ and 11 HIV+/TST+) groups after 6rnmonth of ATT and ART and from 31 (20 HIV+/TB+ and 11 HIV+/TST+) groups after 18 months ofrnART and stored for five years at -80 0C until analyzed for total cholesterol (TC), triglyceride (TG),rnlow density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) usingrnCobas Integra 400 plus. We used stata version 11 for statistical analysis.rnResults: -at baseline, mean level of TC, LDL-C and HDL-C were significantly lower in HIV-TB+,rnHIV+TB+ and HIV+TST+ as compared to HIV-TST+ and HIV-TST-. TG was also significantly lowerrnin HIV+/TB+, HIV-TB+ and HIV+/TST+ than in HIV-TST-. Patients with HIV-/TB+ were alsornsignificantly different from HIV-/TST+ groups for TG levels. On the other hand HIV-TB+, HIV+TB+rnand HIV+TST+ did not differ significantly from each other for most lipid profiles except for HDL-Crnthat was markedly lower in HIV+/TB+ than HIV-/TB+ and HIV+/TST+ groups. After 6 month of ATTrnfor HIV-/TB+ groups, significant increases were observed in TC, LDL-C and HDL-C. Proportion ofrnpatients with abnormal high TC, TG and LDL-C after ATT was very few (≈ 4%). For HIV+/TB+rnpatients, After 4 months of ART and 6 month of ATT, significant increases were observed in TC, TGrnand HDL-C levels. At 18 months, the proportion of patients with TC levels ≥ 200 mg/dl had increasedrnsignificantly, from 0 to 20 % and TG levels > 150 mg/dl from 0 to 30 %. However, the proportion ofrnpatients with HDL-C levels < 40 mg/dl decreased significantly, from 95 % to 50 %. For HIV+/TST+rnpatients, After 6 months of ART, no significant change in all lipid levels. However, after 18 months ofrntreatment, TC levels significantly increased by a mean of 61 mg/dl and LDL-C increased by 37 mg/dlrnConclusion and recommendations: In addition to cardiovascular risk prediction, if confirmed inrnfurther studies with larger sample size and combined with other prognostic clinical and laboratoryrnmarkers, measurement of plasma lipids may allow clinicians and investigators to target patients withrnpulmonary TB in whom microscopy is most likely to yield a pathogen.rnKey words: TB, TB/HIV co-infection, biomarker, lipids, ATT, ART

Get Full Work

Report copyright infringement or plagiarism