Anietie E Moses
University of Uyo, Nigeria
Title: Levels of serum c-reactive protein in predicting tuberculosis disease progression in HIV coinfected persons in resource limited settings
Biography
Biography: Anietie E Moses
Abstract
The challenge of tuberculosis diagnosis in TB/HIV co-infected persons are worrisome especially in resource poor countries. Assessment of some biomarkers’ levels in active tuberculosis could serve as a veritable tool in diagnosing TB in some settings. This study investigates the relationship between C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), absolute CD4+ cell counts and TB/HIV co-infection in sputum-producing patients in Uyo, Nigeria. TB was diagnosed using Ziehl-Neelsen staining and Immunofluorescence techniques. HIV was diagnosed serologically. Total serum CRP levels and CD4+ count were estimated using sandwich-ELISA and Flow cytometry, respectively. Differences in mean serum CRP of TB patients with and without HIV were significant (PHIV-positives alone(20.45±28.5mg/l), >TB-neg/HIV-negatives(12.34±20.9mg/dl), >apparently healthy subjects (0.44±0.64mg/l), as against TB-positives alone(29.83±30.8 mg/l). Mean serum CRP levels in TB-positives alone was significant >the control group(PTB-neg/ HIV-negative group (P<0.05). The pairwise analysis of mean absolute CD4+ counts show that TB/HIV-coinfection (175.12±85.79cells/µl) had a significantly lower count than HIV-positives only (358.93±240.1cells/µl), TB-positives only (576.31±326.3cells/µl) and HIV-neg/TB-negative groups (1089.8±331.3cells/µl). There was no significant difference between the mean CD4+ count among TB-positives and HIV-positives alone. Both groups had significantly lower counts than HIV-neg/TB-negatives. These findings revealed that the use of serum CRP levels alone or in combination with ESR and CD4+ count is a promising predictor of TB disease progression, especially in TB/HIV coinfected persons in high disease burden areas.