Monocyte-to-lymphocyte ratio as a predictor of TB among people living with HIV

• Published in: The international journal of tuberculosis and lung disease Vol. 25; no. 11; pp. 933 - 938
• Main Authors: Gatechompol, S., Sophonphan, J., Kerr, S. J., Ubolyam, S., Avihingsanon, A., van Leth, F., Cobelens, F.
• Format: Journal Article
• Language: English
• Published: France International Union Against Tuberculosis and Lung Disease 01.11.2021; International Union against Tuberculosis and Lung Disease (IUATLD)
• Subjects: Antiretroviral agents; Antiretroviral therapy; Biomarkers; CD4 Lymphocyte Count; Confidence intervals; Diagnostic Tests, Routine; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Incidence; Lymphocytes; Ml Ratio; Monocytes; Peripheral blood; Predictor; Quartiles; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - epidemiology
• ISSN: 1027-3719; 1815-7920; 1815-7920
• DOI: 10.5588/ijtld.21.0300

BACKGROUND: Diagnostic tools to identify incipient or subclinical TB stages will be helpful for preventive intervention. A simple biomarker to predict TB may be the monocytes to lymphocytes ratio (ML ratio) in peripheral blood.METHODS: We assessed the relationship between multiple time-updated ML ratio measurements and incidence of TB in people living with HIV (PLWH) after antiretroviral therapy (ART) was initiated. The ML ratio was updated at least every 6 months. TB incidence with corresponding 95% confidence intervals stratified according to time-updated ML ratio was calculated using ML ratio in quartiles.RESULTS: A total of 1305 PLWH were included in the analyses: 46 had incident TB and 1259 remained TB-free. The TB incidence rate was 10.3 (95% CI 7.1-14.9) cases/1000 patient-years (PYR) among participants with ML ratio ≥0.25 compared with 1.1/1000 PYR (95% CI 0.4-2.9) among those with ML ratio <0.15. At cut-point 0.23, the ML ratio provided a diagnostic area under the receiver operating characteristics curve (AROC) of 0.849 (95% CI 0.784-0.914) and a sensitivity of 85% and specificity of 71%.CONCLUSION: Increased ML ratio was predictive of incident TB among PLWH on or after ART. The ML ratio can be a simple tool to stratify the risk of TB in PLWH.