The Indonesian Biomedical Journal
Vol 13, No 4 (2021)

Higher Neutrophil-lymphocyte Ratio in TB/HIV Co-infection Compared to Pulmonary Tuberculosis

Nuni Sulastri (Faculty of Medicine, Universitas Padjadjaran, Jl. Raya Bandung Sumedang KM 21, Jatinangor 45363)
Bachti Alisjahbana (Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38, Bandung 40161)
Resvi Livia (Department of Clinical Pathology Dr. Hasan Sadikin General Hospital, Jl. Pasteur No. 38, Bandung 40161)
Edhyana Sahiratmadja (Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Jl. Raya Bandung Sumedang KM 21, Jatinangor 45363)



Article Info

Publish Date
31 Dec 2021

Abstract

BACKGROUND: Neutrophils and lymphocytes play a significant role in inflammation and a high ratio of neutrophils over lymphocytes (NLR) has been used as an inflammatory marker to predict the severity of various diseases. Here we compared the NLR among pulmonary tuberculosis and TB/HIV co-infection.METHODS: A retrospective cross-sectional study was conducted, included patients with pulmonary TB without cavitation TB (n=50), with cavitation TB (n=50) and HIV co-infection (n=27). Complete blood count was examined, including neutrophils and lymphocyte. NLR was calculated and compared between groups. RESULTS: Neutrophils were significantly higher (p=0.004) in TB with cavitation compared to those with no cavitation (8.27±1.45 x103/μL vs. 6.61±1.4 x103/μL, respectively); whereas the lymphocytes were similar in both groups, resulting in a significantly higher NLR (p=0.009) in pulmonary TB with cavitation compared to pulmonary TB with no cavitation (5.98±1.85 vs. 4.42±1.86, respectively). On the contrary, both neutrophils as well as lymphocyte were significantly lower in TB/HIV compared to pulmonary TB, which for neutrophil were 5.14±2.19 x103/μL vs. 7.4±1.45 x103/μL, respectively (p=0.003) and for lymphocyte (1.02 ±0.57 x103/μL vs. 1.57±0.64 x103/μL, respectively (p=0.001), resulting in a significantly higher (p=0.041) NLR value in TB/HIV (6.05±2.67) compared to pulmonary TB (5.16±1.88).CONCLUSION: High NLR in pulmonary TB with cavitation as well as in TB with HIV co-infection may be of great interest for biomarker in TB severity. Further study confirming NLR as potential marker is imperative.KEYWORDS: lymphocyte, neutrophil, NLR, tuberculosis, TB/HIV

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