Tuberculosis bacillary load, an early marker of disease severity: the utility of tuberculosis Molecular Bacterial Load Assay



Sabiiti, Wilber, Azam, Khalide, Farmer, Eoghan Charles William, Kuchaka, Davis, Mtafya, Bariki, Bowness, Ruth, Oravcova, Katarina, Honeyborne, Isobella, Evangelopoulos, Dimitrios, McHugh, Timothy Daniel
et al (show 18 more authors) (2020) Tuberculosis bacillary load, an early marker of disease severity: the utility of tuberculosis Molecular Bacterial Load Assay. THORAX, 75 (7). pp. 606-608.

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Abstract

In this comparative biomarker study, we analysed 1768 serial sputum samples from 178 patients at 4 sites in Southeast Africa. We show that tuberculosis Molecular Bacterial Load Assay (TB-MBLA) reduces time-to-TB-bacillary-load-result from days/weeks by culture to hours and detects early patient treatment response. By day 14 of treatment, 5% of patients had cleared bacillary load to zero, rising to 58% by 12th week of treatment. Fall in bacillary load correlated with mycobacterial growth indicator tube culture time-to-positivity (Spearmans r=-0.51, 95% CI (-0.56 to -0.46), p<0.0001). Patients with high pretreatment bacillary burdens (above the cohort bacillary load average of 5.5log<sub>10</sub>eCFU/ml) were less likely to convert-to-negative by 8th week of treatment than those with a low burden (below cohort bacillary load average), p=0.0005, HR 3.1, 95% CI (1.6 to 5.6) irrespective of treatment regimen. TB-MBLA distinguished the bactericidal effect of regimens revealing the moxifloxacin-20 mg rifampicin regimen produced a shorter time to bacillary clearance compared with standard-of-care regimen, p=0.008, HR 2.9, 95% CI (1.3 to 6.7). Our data show that the TB-MBLA could inform clinical decision making in real-time and expedite drug TB clinical trials.

Item Type: Article
Uncontrolled Keywords: tuberculosis, bacterial Infection, respiratory infection
Depositing User: Symplectic Admin
Date Deposited: 09 Jul 2020 07:53
Last Modified: 18 Jan 2023 23:46
DOI: 10.1136/thoraxjnl-2019-214238
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3093288