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Resolution of the acute-phase response in West African patients receiving treatment for pulmonary tuberculosis.
Lawn SD; Obeng J; Acheampong JW; Griffin GE; Department of Infectious
July 30, 2000
Int J Tuberc Lung Dis. 2000 Apr;4(4):340-4. Unique Identifier : AIDSLINE

SETTING: 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. DESIGN: 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. CONCLUSION: 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.

JOURNAL ARTICLE Acute-Phase Reaction/BLOOD/*ETIOLOGY/*IMMUNOLOGY Adult Antitubercular Agents/*THERAPEUTIC USE Biological Markers/BLOOD *Blood Sedimentation *Body Weight C-Reactive Protein/*DRUG EFFECTS/*METABOLISM Case-Control Studies Drug Monitoring Female Ghana Hemoglobins/*ANALYSIS Human Male Receptors, Interleukin-2/*BLOOD Reproducibility of Results Sputum/MICROBIOLOGY Support, Non-U.S. Gov't Time Factors Tuberculosis, Pulmonary/COMPLICATIONS/*DRUG THERAPY/*IMMUNOLOGY/ MICROBIOLOGY