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

 

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dc.contributor.author Kerkhoff, Andrew D en_ZA
dc.contributor.author Wood, Robin en_ZA
dc.contributor.author Lowe, David M en_ZA
dc.contributor.author Vogt, Monica en_ZA
dc.contributor.author Lawn, Stephen D en_ZA
dc.date.accessioned 2015-11-23T12:28:35Z
dc.date.available 2015-11-23T12:28:35Z
dc.date.issued 2013 en_ZA
dc.identifier.citation Kerkhoff, A. D., Wood, R., Lowe, D. M., Vogt, M., & Lawn, S. D. (2013). Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load. PloS one, 8(7), e67956. doi:10.1371/journal.pone.0067956 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15295
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0067956
dc.description.abstract BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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; p = 0.0006) and an aRR of 6.8 (95%CI, 2.3-20.4) for having neutrophilia defined by a neutrophil count exceeding the upper limit of the normal range (ANC >7.5×10 9 /L; p = 0.0005). Patients were then classified into four mutually exclusive groups with increasing sputum mycobacterial load as defined by the results of culture, Xpert MTB/RIF and sputum smear microscopy. Multivariable analyses demonstrated that increasing sputum mycobacterial load was positively associated with blood ANC ≥2.6×10 9 /L and with neutrophilia. Conclusions/Significance Increased blood neutrophil counts were independently associated with pulmonary TB and sputum mycobacterial burden in this HIV-infected patient group. This observation supports the growing body of literature regarding the potential role for neutrophils in the host response to TB. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Mycobacterium tuberculosis en_ZA
dc.subject.other Sputum en_ZA
dc.subject.other Neutrophils en_ZA
dc.subject.other Tuberculosis en_ZA
dc.subject.other Blood counts en_ZA
dc.subject.other Antenatal care en_ZA
dc.subject.other Tuberculosis diagnosis and management en_ZA
dc.subject.other Blood en_ZA
dc.title Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2013 Kerkhoff et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Desmond Tutu HIV Centre en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Kerkhoff, A. D., Wood, R., Lowe, D. M., Vogt, M., & Lawn, S. D. (2013). Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load. <i>PLoS One</i>, http://hdl.handle.net/11427/15295 en_ZA
dc.identifier.chicagocitation Kerkhoff, Andrew D, Robin Wood, David M Lowe, Monica Vogt, and Stephen D Lawn "Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/15295 en_ZA
dc.identifier.vancouvercitation Kerkhoff AD, Wood R, Lowe DM, Vogt M, Lawn SD. Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load. PLoS One. 2013; http://hdl.handle.net/11427/15295. en_ZA
dc.identifier.ris TY - Journal Article AU - Kerkhoff, Andrew D AU - Wood, Robin AU - Lowe, David M AU - Vogt, Monica AU - Lawn, Stephen D AB - BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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; p = 0.0006) and an aRR of 6.8 (95%CI, 2.3-20.4) for having neutrophilia defined by a neutrophil count exceeding the upper limit of the normal range (ANC >7.5×10 9 /L; p = 0.0005). Patients were then classified into four mutually exclusive groups with increasing sputum mycobacterial load as defined by the results of culture, Xpert MTB/RIF and sputum smear microscopy. Multivariable analyses demonstrated that increasing sputum mycobacterial load was positively associated with blood ANC ≥2.6×10 9 /L and with neutrophilia. Conclusions/Significance Increased blood neutrophil counts were independently associated with pulmonary TB and sputum mycobacterial burden in this HIV-infected patient group. This observation supports the growing body of literature regarding the potential role for neutrophils in the host response to TB. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0067956 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load TI - Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load UR - http://hdl.handle.net/11427/15295 ER - en_ZA


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.