Browsing by Author "Amare Yemane"

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    Lipids as Indirect Biomarkers of Pulmonary Tuberculosis in Patients with and Without Hiv Infection in Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-02) Amare Yemane; Kassa Desta
    Background: - Even though some studies have shown that lipids could be indirect markers ofpulmonary tuberculosis (TB), there is no sufficient data from Ethiopia which characterize the level ofthese markers during TB disease and infection. Nonetheless, the effect of HIV co-infection and itstreatment on the level of these makers is not well investigated. Objective: - to determine whether lipids are indirect biomarkers of pulmonary TB in pts with or without HIV infection. Methods: - fasting plasma samples collected from 159 untreated adults visiting various healthinstitutions in Addis Ababa (44 HIV+/TB+, 49 HIV-/TB+, 17 HIV+/TST+, 24 HIV-/TST+ and 25HIV-/TST-) at baseline, from 88 (30 HIV+/TB+, 47 HIV-/TB+ and 11 HIV+/TST+) groups after 6month of ATT and ART and from 31 (20 HIV+/TB+ and 11 HIV+/TST+) groups after 18 months ofART and stored for five years at -80 0C until analyzed for total cholesterol (TC), triglyceride (TG),low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) usingCobas Integra 400 plus. We used stata version 11 for statistical analysis. Results: -at baseline, mean level of TC, LDL-C and HDL-C were significantly lower in HIV-TB+,HIV+TB+ and HIV+TST+ as compared to HIV-TST+ and HIV-TST-. TG was also significantly lowerin HIV+/TB+, HIV-TB+ and HIV+/TST+ than in HIV-TST-. Patients with HIV-/TB+ were alsosignificantly different from HIV-/TST+ groups for TG levels. On the other hand HIV-TB+, HIV+TB+and HIV+TST+ did not differ significantly from each other for most lipid profiles except for HDL-Cthat was markedly lower in HIV+/TB+ than HIV-/TB+ and HIV+/TST+ groups. After 6 month of ATTfor HIV-/TB+ groups, significant increases were observed in TC, LDL-C and HDL-C. Proportion ofpatients with abnormal high TC, TG and LDL-C after ATT was very few (≈ 4%). For HIV+/TB+patients, After 4 months of ART and 6 month of ATT, significant increases were observed in TC, TGand HDL-C levels. At 18 months, the proportion of patients with TC levels ≥ 200 mg/dl had increasedsignificantly, from 0 to 20 % and TG levels > 150 mg/dl from 0 to 30 %. However, the proportion ofpatients with HDL-C levels < 40 mg/dl decreased significantly, from 95 % to 50 %. For HIV+/TST+patients, After 6 months of ART, no significant change in all lipid levels. However, after 18 months oftreatment, TC levels significantly increased by a mean of 61 mg/dl and LDL-C increased by 37 mg/dl Conclusion and recommendations: In addition to cardiovascular risk prediction, if confirmed infurther studies with larger sample size and combined with other prognostic clinical and laboratorymarkers, measurement of plasma lipids may allow clinicians and investigators to target patients withpulmonary TB in whom microscopy is most likely to yield a pathogen. Key words: TB, TB/HIV co-infection, biomarker, lipids, ATT, ART