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 language | English (US) |
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Pages (from-to) | 1115-1121 |
Number of pages | 7 |
Journal | Journal of Infectious Diseases |
Volume | 178 |
Issue number | 4 |
State | Published - 1998 |
Externally published | Yes |
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Immunology