Faculty: Health Sciences And Technology
Department: Medical Laboratory Science
Ihim, A. C.
Meludu, S. C
Enhanced free radical generation during tuberculosis (TB) infection may alter the host antioxidant status and cause lipid peroxidation.The aim of this study was to evaluate the status of antioxidants, lipid peroxidation, apolipoproteins and some atherogenic parameters as prognostic indicators in tuberculosis infection. The objectives were to evaluate the antioxidant and lipid peroxidation status in individuals with active TB infection and to determine the levels of these parameters before, after two and six months treatment in individuals with active Mycobacterium tuberculosis (MTB) infection. This prospective follow up study recruited 159 TB treatment-naive individuals from three major Tuberculosis Directly Observed Treatment Short Course (TB DOTS) Clinics in Anambra State. They were followed up on six-month course anti¬-tuberculosis therapy (ATT). One hundred and twenty individuals completed the follow up. These comprised 82 individuals with active TB, 26 human immunodeficiency virus seropositive individuals co-infected with TB, and 12 individuals with TB and malaria parasite co-infection. Antioxidants, apolipoproteins and free fatty acids (FFA) were measured before ATT, and at two and six months post-treatment. Another batch of 105 individuals served as control, while 26 individuals with latent TB were recruited after testing positive to Mantoux test. Mycobacterium tuberculosis was detected by microscopy and Genexpert methods, while malaria parasite infection was diagnosed by microscopy and rapid diagnostic test. Antioxidants, malondialdehyde (MDA), apolipoproteins, vitamins C and E levels were determined spectrophotometrically and selenium levels by atomic absorption spectrophotometry. Statistical analyses were done using SPSS version 21.The mean serum levels of vitamins E and C, Se and activities of superoxide dismutase (SOD), catalase and glutathione reductase (GRx) were significantly lower in individuals with active TB than those with latent TB and the control (p<0.05). The mean level of MDA and activity of glutathione peroxidase (GPx) were significantly higher in individuals with latent TB and those with active TB compared with the control (p<0.05). There was a significantly higher mean serum level of apolipoprotein B 100 in individuals with active TB (2879.5± 1.03) and those with latent TB (2489.4±0.84) compared with the control (2032.3±1.11) (p<0.05). The mean levels of FFA, MDA, Apo B and B 48 were significantly lower in individuals with active TB at 2months and 6months on ATT compared with the baseline (p<0.05). The mean levels of Apo B100 ,Vitamins E, C, Se, activities of SOD, catalase and GPx were significantly higher in individuals with active TB at 2months and 6months following ATT compared with the baseline (p<0.05) while the mean activity of GRx was significantly higher in individuals with active TB at 6months following ATT compared with those at 2months and baseline (p<0.05). These findings suggest reduced levels of antioxidants in individuals with active M. tuberculosis infection with increased levels of MDA and Apo B100. The observed significantly raised level of Apo B100, even with treatment, indicates a higher risk of cardiovascular disease. Lipid profile and antioxidant levels significantly increased while malondialdehyde, apolipoproteins B and B 48 significantly decreased after treatment indicating good therapeutic response.