Monocyte to lymphocyte blood ratio in tuberculosis and HIV patients: Comparative analysis, preliminary data

Recent data confirmed the hypothesis suggested by historical studies that the ratio of peripheral blood monocytes to lymphocytes (M/L) is associated with the risk of tuberculosis (TB) disease. We retrospectively analyzed the electronic health records of tuberculosis and HIV-positive patients who had followed day-care programs at the AIDS Center of the University of Palermo, Italy. 261 patients were recruited and divided into 6 groups as follows: healthy control group (HCG: 47 pts), latent HIV negative infected TB group (LIG, 43 pts), active HIV negative tuberculosis (TAG: 61 pts), treated tuberculosis HIV negative (TTG: 44 pts), HIV drug-naive patients tested TST and QFT-IT-negative with negative chest x-Ray (HIVnG: 44 pts), and HIV-tuberculosis coinfection (HIVTB-G: 22 pts). For each group, absolute lymphocyte (L), monocyte (M) and M/L ratio by peripheral blood was calculated. The mean value of monocytes in the TAG group was significant, the highest (0.70±0.37 1x103/μl) in comparison to HGC (0.70>0.44, p-value <0.05), HIVnG (0.70>0.40, p-value <0.05) and HIVTB-G (0.70>0.45, p-value<0.05). Monocyte to lymphocyte blood RATIO showed a significant difference between groups (p-value <0.001). In particular, the mean score of M/L ratio was higher in the TAG group compared to the HGC (0.49>0.27, p-value<0.05), LIG (0.49>0.29, p-value<0.05), TTG (0.49>0.32) and HIVTB-G groups (0.49>0.27, p-value<0.05). Our data confirm a significant difference in monocyte to lymphocyte blood ratio in tuberculosis disease. These data may be useful for monitoring and revising implementation plans for the different phases of tuberculosis disease (latent Mycobacterium tuberculosis (MTB) infection versus TB active disease). Regarding HIV samples, the small sample size is somewhat offset by the need, fully satisfied in our sample, to enlist specific patients such as co-infected HIV/TBC who voluntarily submit to clinical trials in our geographical area