The serum concentration of vitamin B12 as a biomarker of therapeutic response in tuberculosis patients with and without human immunodeficiency virus (HIV) infection

Gebremedhin Gebremicael; Mihret Alemayehu; Meron Sileshi; Zeleke Geto; Atsbeha Gebreegziabxier; Hulumtaye Tefera; Nigat Ashenafi; Chere Tadese; Mistire Wolde; Desta Kassa

doi:10.2147/IJGM.S218799

The serum concentration of vitamin B₁₂ as a biomarker of therapeutic response in tuberculosis patients with and without human immunodeficiency virus (HIV) infection

Int J Gen Med. 2019 Sep 20:12:353-361. doi: 10.2147/IJGM.S218799. eCollection 2019.

Affiliations

¹ HIV and TB Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia.
² Department of Medical Laboratory Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
³ Nutrition and Food Science Research Directorate, Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia.

Abstract

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: Vitamin B12; anti-TB treatment; biomarker of diagnostic; retinol; vitamin A.