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

TitleInduction of the antigen 85 complex of Mycobacterium tuberculosis in sputum: a determinant of outcome in pulmonary tuberculosis treatment.
Publication TypeJournal Article
Year of Publication1998
AuthorsWallis, RS, Perkins, M, Phillips, M, Joloba, M, Demchuk, B, Namale, A, Johnson, JL, Williams, D, Wolski, K, Teixeira, L, Dietze, R, Mugerwa, RD, Eisenach, K, Ellner, JJ
JournalThe Journal of infectious diseases
Volume178
Issue4
Pagination1115-21
Date Published1998 Oct
ISSN0022-1899
KeywordsAdult, Antigens, Bacterial, Antitubercular Agents, Brazil, Cell Wall, Drug Resistance, Multiple, Humans, Middle Aged, Mycobacterium tuberculosis, Mycolic Acids, Sputum, Treatment Failure, Treatment Outcome, Tuberculosis, Pulmonary, Uganda
Abstract

Sputum quantitative culture, acid-fast smear, days-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 day 90. All subjects with day 14 antigen 85 complex values < 60 pg/mL responded rapidly to treatment and were cured. Of those with 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.

Alternate JournalJ. Infect. Dis.
Full Text
PubMed ID9806042
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