Induction of the antigen 85 complex of Mycobacterium tuberculosis in sputum: A determinant of outcome pulmonary tuberculosis treatment

Robert S. Wallis, Mark Perkins, Manijeh Phillips, Moses Joloba, Barbara Demchuk, Alice Namale, John L. Johnson, Donna Williams, Kathy Wolski, Lucileia Teixeira, Reynaldo Dietze, Roy D. Mugerwa, Kathleen Eisenach, Jerrold J. Ellner

Research output: Contribution to journalArticlepeer-review

Abstract

Sputum quantitative culture, acid-fast smear, day-to-positive by BACTEC, and Mycobacterium tuberculosis antigen 85 complex were monitored during therapy in 42 patients with pulmonary tuberculosis (TB). By BACTEC, 4 patients were persistently positive on days 90-180, and treatment ultimately failed in 2 of these. Antigen 85 expression increased in subjects in whom disease persisted (persisters) from days 0 to 14 when the difference between persisters and nonpersisters was statistically significant (P = .002). Only antigen 85 complex values at day 14 suggested TB persistence at or after 90 day. All subjects with day 14 antigen 85 complex values 60 pg/ml, in 33% TB persisted at or after day 90 and treatment failed in 17%. Biologic factors expressed early in therapy, not related to compliance or resistance, may exert a substantial influence on outcome. The antigen 85 complex is critical in cell wall biosynthesis and is induced by isoniazid in vitro. Its induction may represent an adaptive transition to a persistent state during therapy.

Original languageEnglish (US)
Pages (from-to)1115-1121
Number of pages7
JournalJournal of Infectious Diseases
Volume178
Issue number4
StatePublished - 1998
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

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