Plasma levels of C-Reactive Protein and Fibrinogen in Pulmonary Tuberculosis Patients in Ibadan, Southwest, Nigeria

Abstract

Tuberculosis (TB) is an infectious disease which remains a global health problem till date. A number of cytokine and chemokine have been reported to be associated with MTB clearance, reactivation or cure but there are no consensus biomarkers to differentiate the severity of TB. In this study, we determined the changes in plasma C- reactive protein (C-RP) and Fibrinogen levels in Drug sensitive Tuberculosis (DSTB) patients at diagnosis, Multi drug resistant tuberculosis (MDRTB) patients at diagnosis and during chemotherapy. Twenty-four (24) patients MDRTB patients and 24 newly diagnosed DSTB patients from University College Hospital (UCH) Ibadan, Nigeria were recruited for the study by a Consultant Chest physician using clinical history, Chest X-ray and GENE Xpert test. Five (5) milliliters of blood was drawn from the anti-cubital fossa vein into lithium heparin tubes before the commencement of chemotherapy, 2 months, 4 months and 6 months of anti-TB therapy. Plasma obtained was analyzed for C-RP and fibrinogen using ELISA. Data was presented as mean ± SD. Student t-test was used for mean comparison. Statistical significance was set at p ≤ 0.05. Mean CRP level in multi-drug resistant tuberculosis patients was significantly higher at diagnosis compared with controls. Mean fibrinogen levels in the drug sensitive and multi drug resistant tuberculosis were significantly lower at diagnosis compared to controls. The mean CRP and fibrinogen levels in multi-drug resistant tuberculosis were significantly reduced during chemotherapy compared with before commencement of chemotherapy. Plasma CRP and fibrinogen are suggested as possible markers for monitoring treatment response in MDRTB patients.

Keywords; Tuberculosis, Treatment monitoring, Acute phase proteins, drug resistant.