Clinical severity of pulmonary Tuberculosis (TB) is associated with Hypocholesterolemia among adult patients in Uganda.

BACKGROUND

Hypocholesterolaemia in pulmonary tuberculosis(TB) patients is disregarded but is a predictor of poor survival.

OBJECTIVES

To determine serum lipid profile differences at diagnosis and various times of medication based on sex, HIV(human immune virus) and wasting status and factors associated with hypocholesterolaemia.

METHODS

A repeated cross-sectional study was conducted to assess triglyceride(TG), total cholesterol (TC), high-density lipoprotein(HDL) and low-density lipoprotein(LDL) among 414 participants.

RESULTS

Majority of the participants were males(239/414)(58%), with a median age of 28years. TB patients showed significantly lower lipid profile at diagnosis regardless of HIV-status and sex. Presence of anaemia among HIV-seropositive participants with TB, prevalence ratio(PR):2.6, 95%confidence interval(CI):1.0-7.1, p<0.05) and HIV-seronegative participants with TB(PR:2.5, 95%CI:1.1-5.5, p<0.05), moderate/severe TB(PR:2.5,95%CI:1.1-5.5, p<0.05) and CD4 cells>200(PR:0.3 95%CI:0.1-0.8, p<0.05) among HIV-seropositive participants with TB were associated with HDL-hypocholesterolaemia. Male sex, moderate/severe TB, body wasting, dyspnoea and chest pain were independently associated with TC-hypocholesterolaemia. Regardless of sex and wasting status, the pattern of cholesterol recovery was similar at varying times.

CONCLUSION

We envisage that hypocholesterolemia is a marker of clinical TB-disease severity and its recovery indicates treatment response.