Hematological Biomarkers in Tuberculosis Diagnosis and Prognosis
Summary
Tuberculosis (TB) remains a leading cause of infectious mortality worldwide, and there is an urgent need for accessible tools that complement microbiological and radiological assessments. Haematological biomarkers—quantitative and qualitative measures derived from routine blood counts and simple inflammatory assays—have shown promise in reflecting disease activity, predicting treatment response and stratifying patient risk. Changes in leukocyte subsets, acute‐phase proteins and composite ratios can mirror the host immune response to Mycobacterium tuberculosis, distinguishing active from latent infection, forecasting culture conversion and anticipating adverse outcomes such as drug resistance or treatment failure. Their low cost, rapid turnaround and wide availability make these markers particularly attractive in resource-limited settings, where advanced molecular diagnostics may not be readily accessible. Integrating such measures with clinical and microbiological data offers a more nuanced view of disease dynamics, guiding individualised management and informing public health strategies aimed at reducing the global burden of TB.
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Hematological Biomarkers in Tuberculosis Diagnosis and Prognosis publication trend
The graph below shows the total number of articles in hematological biomarkers in tuberculosis diagnosis and prognosis across all publications each year (not limited to Nature Index journals).
Technical terms
Neutrophil-to-lymphocyte ratio (NLR): The quotient of absolute neutrophil count divided by absolute lymphocyte count, reflecting balance between innate and adaptive immunity.
Monocyte-to-lymphocyte ratio (MLR): The ratio of monocyte count to lymphocyte count, used to gauge monocyte-driven inflammation versus lymphocyte-mediated immunity.
Platelet-to-lymphocyte ratio (PLR): The number of platelets divided by lymphocyte count, indicative of thrombo-inflammatory status.
C-reactive protein (CRP): An acute-phase protein produced by the liver in response to inflammation, often elevated in active TB.
Erythrocyte sedimentation rate (ESR): A nonspecific measure of inflammation determined by the rate at which red blood cells settle in anticoagulated blood.
Sputum culture conversion (SCC): The change from a positive to a negative mycobacterial culture during treatment, used as a surrogate marker of microbiological response.
References
- Neutrophil-to-lymphocyte ratio and its association with latent tuberculosis infection and all-cause mortality in the US adult population: a cohort study from NHANES 2011–2012. Frontiers in Nutrition (2024).
- The survival analysis of rifampicin/multidrug-resistant tuberculosis patients based on the levels of inflammatory biomarkers: a retrospective cohort study. Frontiers in Cellular and Infection Microbiology (2023).
- A longitudinal prospective study of active tuberculosis in a Western Europe setting: insights and findings. Infection (2024).
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