Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load

PloS One
Andrew D KerkhoffStephen D Lawn

Abstract

Increasing evidence suggests that neutrophils play a role in the host response to Mycobacterium tuberculosis. We determined whether neutrophil counts in peripheral blood are associated with tuberculosis (TB) and with mycobacterial load in sputum in HIV-infected patients. Adults enrolling in an antiretroviral treatment (ART) clinic in a Cape Town township were screened for TB regardless of symptoms. Paired sputum samples were examined using liquid culture, fluorescence microscopy, and the Xpert MTB/RIF assay. Absolute neutrophil counts (ANC) were measured in blood samples. Of 602 HIV-infected patients screened, 523 produced one or more sputum samples and had complete results available for analysis. Among these 523 patients, the median CD4 count was 169×10(9)/L (IQR, 96-232) and median ANC was 2.6×10(9)/L (IQR, 1.9-3.6). Culture-positive pulmonary tuberculosis was diagnosed in 89 patients. Patients with TB had a median ANC of 3.4×10(9)/L (IQR, 2.4-5.1) compared to 2.5×10(9)/L (IQR, 1.8-3.4) among those who were culture negative (p<0.0001). In multivariable analyses, having pulmonary TB was associated with an adjusted risk ratio (aRR) of 2.6 (95%CI, 1.5-4.5) for having an ANC level that exceeded the median value (ANC ≥2.6×10(9)/L;...Continue Reading

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Citations

Feb 26, 2016·Scientific Reports·Rebecca J NusbaumJanice J Endsley
Jan 1, 2019·PloS One·Abdu Kisekka MusubireCOAT and ASTRO trial teams
Jul 12, 2018·Open Forum Infectious Diseases·Kristina L BajemaRenee Heffron
Jul 20, 2018·Clinical Microbiology Reviews·Paul K DrainDavid R Sherman
Jun 8, 2019·The Cochrane Database of Systematic Reviews·David J HorneKaren R Steingart
Jan 14, 2017·Microbiology Spectrum·Elsa Du Bruyn, Robert J Wilkinson

Methods Mentioned

BETA
fluorescence microscopy
ELISA
X-ray

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