TY - JOUR
T1 - Association of baseline white blood cell counts with tuberculosis treatment outcome
T2 - a prospective multicentered cohort study
AU - Chedid, Carole
AU - Kokhreidze, Eka
AU - Tukvadze, Nestani
AU - Banu, Sayera
AU - Uddin, Mohammad Khaja Mafij
AU - Biswas, Samanta
AU - Russomando, Graciela
AU - Acosta, Chyntia Carolina Díaz
AU - Arenas, Rossana
AU - Ranaivomanana, Paulo PR
AU - Razafimahatratra, Crisca
AU - Herindrainy, Perlinot
AU - Rakotosamimanana, Niaina
AU - Hamze, Monzer
AU - Ismail, Mohamad Bachar
AU - Bayaa, Rim
AU - Berland, Jean Luc
AU - Delogu, Giovanni
AU - Endtz, Hubert
AU - Ader, Florence
AU - Goletti, Delia
AU - Hoffmann, Jonathan
PY - 2020/11
Y1 - 2020/11
N2 - 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.
AB - 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.
KW - Immunomonitoring
KW - Lymphopenia
KW - Multi-drug resistance
KW - Treatment monitoring
KW - Tuberculosis
KW - White blood cells
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U2 - 10.1016/j.ijid.2020.09.017
DO - 10.1016/j.ijid.2020.09.017
M3 - Article
C2 - 32920230
AN - SCOPUS:85091750766
VL - 100
SP - 199
EP - 206
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -