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Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: Association with sputum mycobacterial load
PLoS One
  • Andrew D. Kerkhoff, George Washington University
  • Robin Y. Wood, University of Cape Town, Cape Town, South Africa
  • David M. Lowe, Imperial College London, London, United Kingdom
  • Monica Vogt, University of Cape Town, Cape Town, South Africa
  • Stephen D. Lawn, University of Cape Town, Cape Town, South Africa
Document Type
Journal Article
Publication Date
7-9-2013
Inclusive Pages
Article number e67956
Keywords
  • Coinfection,
  • HIV Infections--blood,
  • Leukocyte Count,
  • Neutrophils,
  • Sputum--microbiology,
  • Tuberculosis, Pulmonary--blood
Abstract

Background

Increasing evidence suggests that neutrophils play a role in the host response toMycobacterium 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 169×109/L (IQR, 96–232) and median ANC was 2.6×109/L (IQR, 1.9–3.6). Culture-positive pulmonary tuberculosis was diagnosed in 89 patients. Patients with TB had a median ANC of 3.4×109/L (IQR, 2.4–5.1) compared to 2.5×109/L (IQR, 1.8–3.4) among those who were culture negative (p7.5×109/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 ≥2.6×109/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.

Comments

Reproduced with permission of PLoS ONE

Creative Commons License
Creative Commons Attribution 3.0
Peer Reviewed
1
Open Access
1
Citation Information
Andrew D. Kerkhoff, Robin Y. Wood, David M. Lowe, Monica Vogt, et al.. "Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: Association with sputum mycobacterial load" PLoS One Vol. Volume 8, Issue 7 (2013)
Available at: http://works.bepress.com/andrew_kerkhoff/1/