To Assess The Efficacyof Acute Phase Reactants &Monocyte: Lymphocyte (M/L) Ratio As A Prognostic Marker In Anti-TB Drug Therapy.

Abstract

Background: In Tuberculosis, acute phase reactants (APR) like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) has been commonly used for monitoring the treatment. This study was undertaken to assess monocyte lymphocyte ratio (M/L ratio) as a biomarker to see the outcome of therapy and progress of TB.Results: The pre-treatment lymphocyte and monocyte count in the study group were significantly different from the control group, while M/L ratio was similar in both the groups post treatment. The mean M/L ratio in cases and controls were 0.3± 0.14 and0.140± 0.06respectively. The M/L ratio significantly decreased after treatment to0.145±0.07 with p value of<0.05. Conclusion:Even though ESR & CRP are increased in TB and their level decreases during the course of treatment but both these biomarkers are not specific for TB &are influenced by certain factors.M/L ratio is high in active TB and the ratio gradually reduces during the treatment.M/L ratio is not influenced by other factors. On the basis of this study it can be safely concluded that M/L ratio is better biomarker than ESR and CRP in predicting the activity & hence prognosis of TB during the treatment.Take home message - TB is associated with increased M/L ratio, which declines and returns to normal with anti-tuberculous therapy>