Evaluation of serum inflammatory biomarkers as predictors of treatment outcome in pulmonary tuberculosis

Objectives: The aim was to evaluate routinely measured serum biomarkers CRP, total globulin and white cell count as predictors of treatment outcome in tuberculosis. Methods: An observational study of patients with pulmonary tuberculosis was conducted at a tertiary centre. All patients had serum biomarkers measured at baseline and two months following commencement of therapy. The outcome of interest was requirement for extension of therapy beyond 6 months. Results: 226 patients were included. 87 patients(38.5%) required therapy extension. Serum globulin was the only baseline biomarker evaluated that was an independent predictor of requirement for therapy extension(OR 3.59(1.79–7.57;p <0.001)) An elevated globulin that failed to normalize at 2 months was associated with increased requirement for treatment extension(63.9% versus 5.1%;p Conclusions: Serum globulin independently predicts requirement for treatment extension in pulmonary TB and outperforms CRP and white cell count as a predictive biomarker. Normalization of globulin at two months following treatment commencement is associated with low risk of adverse outcome.