C-reactive protein (CRP) levels are significantly elevated in individuals with tuberculosis (TB), and these levels decrease following effective anti-TB treatment. Here's a detailed explanation:
CRP Levels in TB Patients
CRP is an acute-phase reactant, meaning its concentration in the blood increases during inflammation. In the context of TB, the body's inflammatory response to the Mycobacterium tuberculosis bacteria leads to elevated CRP levels.
CRP at Diagnosis
- Mean CRP concentration at diagnosis: 114.7 mg/L (95% CI: [83.8 – 145.6]). This indicates a substantial inflammatory response due to the active TB infection.
- This high level serves as an indicator of the severity of the infection.
CRP After Treatment
- Mean CRP concentration 4 weeks after starting anti-TB treatment: 20.2 mg/L (95% CI: [14.1 – 26.4]).
- This marks a significant reduction in CRP, which reflects a positive response to the treatment and decreasing inflammation.
- Significant Decrease: The drop in CRP concentrations from diagnosis to 4 weeks after treatment is statistically significant (p < 0.0001). This shows that anti-TB treatment is effectively reducing the inflammatory process.
Significance of CRP in TB Management
- Diagnostic Aid: While not specific to TB, high CRP levels are often observed alongside other diagnostic tests for TB.
- Treatment Monitoring: CRP levels can be used to monitor the effectiveness of anti-TB treatment. A decreasing trend indicates that the treatment is working.
- Prognostic Indicator: Persistently high CRP levels might suggest poor treatment adherence, drug resistance, or the presence of co-morbidities that complicate TB treatment.
Example of CRP Monitoring:
- A patient presents with TB and a CRP level of 130 mg/L. After four weeks of treatment, their CRP is down to 25 mg/L, indicating a positive response. However, if CRP levels remained unchanged or increased, it would warrant further investigation and treatment adjustments.
| Timepoint | Mean CRP Concentration (mg/L) | 95% Confidence Interval |
|---|---|---|
| At TB Diagnosis | 114.7 | [83.8 – 145.6] |
| 4 Weeks Post Anti-TB Treatment | 20.2 | [14.1 – 26.4] |
Therefore, CRP is a useful biomarker for assessing inflammation in TB patients, aiding both diagnosis and monitoring treatment effectiveness.
