Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults.

<h4>Background</h4>The tuberculin skin test (TST) identifies individuals at high risk of developing tuberculosis (TB) but poses many challenges. The blood monocyte-to-lymphocyte ratio (MLR) could be an alternative, as extremes in MLR have been associated with increased risk of TB disease...

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Autores principales:	Eva Van Ginderdeuren, Jean Bassett, Colleen F Hanrahan, Annelies Van Rie
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/359f158c3d2b43c8b99734175fedcc87
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spelling	oai:doaj.org-article:359f158c3d2b43c8b99734175fedcc872021-12-02T20:06:56ZAssociation between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults.1932-620310.1371/journal.pone.0253907https://doaj.org/article/359f158c3d2b43c8b99734175fedcc872021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253907https://doaj.org/toc/1932-6203<h4>Background</h4>The tuberculin skin test (TST) identifies individuals at high risk of developing tuberculosis (TB) but poses many challenges. The blood monocyte-to-lymphocyte ratio (MLR) could be an alternative, as extremes in MLR have been associated with increased risk of TB disease.<h4>Methods</h4>At a primary care clinic in Johannesburg, a differential white blood cell count and TST was performed in adults starting antiretroviral treatment (ART) without symptoms suggestive of active TB.<h4>Results</h4>Of 259 participants, 171 had valid results of whom 30% (51/171) were TST positive and the median MLR was 0.18 (IQR 0.13-0.28). The MLR distribution differed between CD4 count categories (p < 0.01), with a broader range of values in TST negative participants with a low CD4 count (≤ 250 cells/mm3), likely reflecting HIV immunosuppression. MLR was associated with a positive TST (OR 0.78 per 0.1 increase, 95% CI 0.59, 0.97) in bivariate analysis but not in multivariate regression analysis (aOR 0.83 for every 0.1 increase, 95% CI 0.60, 1.08).<h4>Conclusion</h4>In ART-naïve adults without symptoms suggestive of active TB, MLR was not independently associated with TST positivity and is thus unlikely to be a useful alternative to TST. Future research should focus on development of a cheap, simple and accurate biomarker to identify those people benefiting most from preventive TB therapy.Eva Van GinderdeurenJean BassettColleen F HanrahanAnnelies Van RiePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253907 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Eva Van Ginderdeuren Jean Bassett Colleen F Hanrahan Annelies Van Rie Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults.
description	<h4>Background</h4>The tuberculin skin test (TST) identifies individuals at high risk of developing tuberculosis (TB) but poses many challenges. The blood monocyte-to-lymphocyte ratio (MLR) could be an alternative, as extremes in MLR have been associated with increased risk of TB disease.<h4>Methods</h4>At a primary care clinic in Johannesburg, a differential white blood cell count and TST was performed in adults starting antiretroviral treatment (ART) without symptoms suggestive of active TB.<h4>Results</h4>Of 259 participants, 171 had valid results of whom 30% (51/171) were TST positive and the median MLR was 0.18 (IQR 0.13-0.28). The MLR distribution differed between CD4 count categories (p < 0.01), with a broader range of values in TST negative participants with a low CD4 count (≤ 250 cells/mm3), likely reflecting HIV immunosuppression. MLR was associated with a positive TST (OR 0.78 per 0.1 increase, 95% CI 0.59, 0.97) in bivariate analysis but not in multivariate regression analysis (aOR 0.83 for every 0.1 increase, 95% CI 0.60, 1.08).<h4>Conclusion</h4>In ART-naïve adults without symptoms suggestive of active TB, MLR was not independently associated with TST positivity and is thus unlikely to be a useful alternative to TST. Future research should focus on development of a cheap, simple and accurate biomarker to identify those people benefiting most from preventive TB therapy.
format	article
author	Eva Van Ginderdeuren Jean Bassett Colleen F Hanrahan Annelies Van Rie
author_facet	Eva Van Ginderdeuren Jean Bassett Colleen F Hanrahan Annelies Van Rie
author_sort	Eva Van Ginderdeuren
title	Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults.
title_short	Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults.
title_full	Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults.
title_fullStr	Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults.
title_full_unstemmed	Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults.
title_sort	association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in hiv-positive adults.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/359f158c3d2b43c8b99734175fedcc87
work_keys_str_mv	AT evavanginderdeuren associationbetweenmonocytetolymphocyteratioandtuberculinskintestpositivityinhivpositiveadults AT jeanbassett associationbetweenmonocytetolymphocyteratioandtuberculinskintestpositivityinhivpositiveadults AT colleenfhanrahan associationbetweenmonocytetolymphocyteratioandtuberculinskintestpositivityinhivpositiveadults AT anneliesvanrie associationbetweenmonocytetolymphocyteratioandtuberculinskintestpositivityinhivpositiveadults
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Association between monocyte-to-lymphocyte ratio and tuberculin skin test positivity in HIV-positive adults.

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