Monocyte to Lymphocyte ratio is highly specific in diagnosing latent tuberculosis and declines significantly following tuberculosis preventive therapy: A cross-sectional and nested prospective observational study

Interferon-gamma release assay and tuberculin skin test use is limited by costly sundries and cross-reactivity with non-tuberculous mycobacteria and Bacille Calmette-Guérin (BCG) vaccination respectively. We investigated the Monocyte to Lymphocyte ratio (MLR) as a biomarker to overcome these limitat...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2023-11, Vol.18 (11), p.e0291834-e0291834
Main Authors: Mayito, Jonathan, Meya, David B, Miriam, Akia, Dhikusooka, Flavia, Rhein, Joshua, Sekaggya-Wiltshire, Christine
Format: Article
Language:English
Subjects:
Adult
Antiviral agents
BCG
BCG Vaccine
BCG vaccines
Biology and Life Sciences
Blood
Care and treatment
Cross-Sectional Studies
Diagnosis
Female
Health aspects
Highly active antiretroviral therapy
HIV Infections
Humans
Interferon-gamma Release Tests
Latent Tuberculosis - diagnosis
Lymphocytes
Male
Medical examination
Medicine and Health Sciences
Monocytes
Mycobacterium tuberculosis
Tuberculin Test
Tuberculosis
Uganda - epidemiology
Vaccination
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Interferon-gamma release assay and tuberculin skin test use is limited by costly sundries and cross-reactivity with non-tuberculous mycobacteria and Bacille Calmette-Guérin (BCG) vaccination respectively. We investigated the Monocyte to Lymphocyte ratio (MLR) as a biomarker to overcome these limitations and for use in monitoring response to tuberculosis preventive therapy (TPT). We conducted a cross-sectional and nested prospective observational study among asymptomatic adults living with Human Immuno-deficiency Virus (HIV) in Kampala, Uganda. Complete blood count (CBC) and QuantiFERON-TB® Gold-plus were measured at baseline and CBC repeated at three months. Multivariable logistic regression was performed to identify factors associated with a high MLR and decline in MLR. We recruited 110 adults living with HIV and on antiretroviral therapy, of which 82.5% (85/110) had suppressed viral loads, 71.8% (79/110) were female, and 73.6% (81/110) had a BCG scar. The derived MLR diagnostic cut-off was 0.35, based on which the MLR sensitivity, specificity, positive predictive value, and negative predictive value were 12.8%, 91.6%, 45.5%, and 65.7% respectively. The average MLR declined from 0.212 (95% CI: 0.190-0.235) at baseline to 0.182 (95% CI: 0.166-0.198) after three months of TPT. A viral load of >50 copies/ml (aOR, 5.67 [1.12-28.60]) was associated with a high MLR while that of
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0291834