https://scholars.lib.ntu.edu.tw/handle/123456789/535448
標題: | Dynamics of plasma cytokine levels in patients with advanced HIV infection and active tuberculosis: Implications for early recognition of patients with poor response to anti-tuberculosis treatment | 作者: | SZU-MIN HSIEH CHIEN-CHING HUNG Chen M.-Y. WANG-HUEI SHENG SHAN-CHWEN CHANG |
公開日期: | 1999 | 卷: | 13 | 期: | 8 | 起(迄)頁: | 935-941 | 來源出版物: | AIDS | 摘要: | Objective: To examine whether the serial measurement of plasma cytokine levels can assist in the early recognition of AIDS/tuberculosis patients with poor response to anti-tuberculosis treatment. Design: Longitudinal, prospective cohort study. Setting: A university hospital, the largest centre for HIV/AIDS patients in Taiwan. Methods: Between January 1997 and September 1998, 25 consecutive patients with advanced HIV infection and suspected tuberculosis were enrolled in the study. Plasma samples were obtained on day 1 (baseline), 3, 7 and 14 of anti-tuberculosis treatment and the levels of tumour necrosis factor-α (TNF-α) were measured. Patients were classified as either responders or non-responders according to the results of assessment of symptoms and follow-up cultures during the sixth and eighth week of anti-tuberculosis treatment. Thirty consecutive HIV-negative tuberculosis patients were also enrolled in the study. Results: The data of a total of 16 AIDS patients (median CD4 cell count 16 x 106/l; 12 responders and four non-responders) and 21 HIV-negative patients (16 responders and five non-responders), whose tuberculosis was culture-proven, were included for analysis. In responders, TNF-α levels declined remarkably within the first week of anti-tuberculosis treatment; however, the decline of TNF-α levels in non-responders was significantly less [the median ratio of TNF-α level on day 7 to that at baseline was 0.32 versus 0.85 (P < 0.001) in AIDS patients; 0.34 versus 0.80 (P = 0.001) in HIV-negative patients). The lack of a ? 50% reduction in pre-treatment TNF-α levels during the first week of treatment was strongly associated with a poor response to anti-tuberculosis treatment (P = 0.001 in AIDS patients; P < 0.001 in HIV-negative patients). Conclusion: Serial measurement of plasma TNF-α levels may help to assess the response to anti-tuberculosis treatment in AIDS patients, in spite of very low CD4 cell counts. Failure of TNF-α levels to decline by ? 50% of pre-treatment levels in the first week of treatment may be an early surrogate marker of a poor response. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0033007830&doi=10.1097%2f00002030-199905280-00009&partnerID=40&md5=dffa5ad6b6982380659123ca442c63f2 https://scholars.lib.ntu.edu.tw/handle/123456789/535448 |
ISSN: | 0269-9370 | DOI: | 10.1097/00002030-199905280-00009 | SDG/關鍵字: | cd4 antigen; cytokine; tuberculostatic agent; tumor necrosis factor alpha; acquired immune deficiency syndrome; adult; article; bacterium culture; cohort analysis; early diagnosis; female; follow up; human; human cell; human immunodeficiency virus infection; leukocyte count; major clinical study; male; priority journal; prospective study; tuberculosis; Adult; AIDS-Related Opportunistic Infections; Antitubercular Agents; Cohort Studies; Cytokines; Female; Humans; Interleukin-10; Longitudinal Studies; Male; Microbial Sensitivity Tests; Mycobacterium tuberculosis; Prospective Studies; Treatment Outcome; Tuberculosis; Tumor Necrosis Factor-alpha |
顯示於: | 醫學系 |
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