TB Portals Program: Exploring the association between biochemistry parameters and clinical outcomes in patients with tuberculosis

Authors

  • Y Yi
  • MP Peyton
  • G Rosenfeld
  • AE Gabrielian
  • ZR Yaniv
  • MA Harris
  • A Rosenthal
  • DE Hurt

Abstract

Tuberculosis (TB) is a devastating infectious disease responsible for more than 1.6 million deaths worldwide in 2023. Clinical biochemistry parameters play an important role in optimizing TB treatments by providing valuable clinical information of health status at onset of illness and during the treatment. This study aimed to investigate the association between pre-treatment biochemistry parameters and clinical outcomes to assist doctors in their identification of potentially higher-risk TB patients. We utilized data from the TB Portals, a web-based repository of multi-domain TB data, comprising over 13,000 TB patient cases from 19 countries. The analysis focused on adult TB patients with known treatment outcomes of microbiologically confirmed TB, without reported comorbidities. The distribution of normal and abnormal values (based on UCSF Health standards) for each biochemistry test was compared, revealing several tests with high proportion of abnormal values (e.g., aspartate aminotransferase (AST) (42.44%), albumin (21.50%), creatinine (20.61%), alanine aminotransferase (ALT) (29.87%), and erythrocyte sedimentation rate (ESR) (63.14%)). Stratified analysis with demographic factors (e.g., gender, TB drug resistance type, etc.) were further conducted to assess the association using chi-square tests. Significant associations were found between biochemistry tests (AST, creatinine, ALT, ESR, albumin, and urea) and clinical outcomes (i.e., p-values<0.048). These results suggest that several biochemistry parameters are indicative of higher-risk TB cases. Clinical implications of results will be evaluated with clinical specialists, participating in TB Portals Program. Future research efforts may be necessary to investigate these associations in the context of other factors (e.g., comorbidity, drug-resistance status of the TB strain, etc.).

Scientific Focus Area: Microbiology and Infectious Diseases

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