The serum concentration of vitamin B12 as a biomarker of therapeutic response in tuberculosis patients with and without human immunodeficiency virus (HIV) infection
Received 9 June 2019
Accepted for publication 3 September 2019
Published 20 September 2019 Volume 2019:12 Pages 353—361
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Gebremedhin Gebremicael,1 Mihret Alemayehu,2 Meron Sileshi,1 Zeleke Geto,1 Atsbeha Gebreegziabxier,1 Hulumtaye Tefera,3 Nigat Ashenafi,3 Chere Tadese,3 Mistire Wolde,2 Desta Kassa1
1HIV and TB Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia; 2Department of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Nutrition and Food Science Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
Correspondence: Gebremedhin Gebremicael
HIV and TB Research Directorate, Ethiopian Public Health Institute, P.O.Box 1242, Addis Ababa, Ethiopia
Tel +251 91 334 5910
Background: Prior to clinical trials of new tuberculosis (TB) drugs or therapeutic vaccines, it is necessary to develop monitoring tools to predict treatment outcomes in TB patients.
Methods: Micronutrients concentration level was determined from a total of 262 study participants with five clinical groups: 57 TB patients coinfected with HIV (HIV+TB+), 87 active TB Patients (TB cases), 71 HIV infected without active and latent TB infection (HIV+TST-), 22 latent TB infection (TST+) and 25 healthy controls (TST-). Vitamin A concentration was measured using high-performance liquid chromatography (HPLC), whereas iron and vitamin B12 concentrations were measured using Cobas® 6000 analyzer.
Result: The serum concentration levels of iron, vitamin A and vitamin B12 had a significant difference between active TB and latent (LTBI) or healthy controls. Six months after treatment, the serum concentration levels of vitamin A, vitamin B12 and iron in tuberculosis became indistinguishable from the levels of LTBIs and healthy control individuals. The concentration levels of iron and vitamin B12 in HIV+TB+patients at the end of TB treatment were normalized to the levels observed in healthy controls (TST–) regardless of HAART treatment. However, the concentration level of vitamin A in HIV+TB+patients HAART untreated at the end of TB treatment was not normalized to the levels observed in healthy controls (TST–) or HAART untreated HIV+TST–.
Conclusion: Detecting serum concentration levels of vitamin B12 and vitamin A might be used as a biomarker of the diagnostic method of active TB regardless of HIV-infected individuals. Moreover, detecting serum concentration of vitamin B12 might also be used for TB treatment responses monitoring biomarker in TB-HIV-co-infected individuals regardless of HAART (in)eligibility and therapy.
Keywords: biomarker of diagnostic, vitamin A, Vitamin B12, anti-TB treatment, retinol
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