Serum Albumin/Globulin ratio in Tuberculosis and HIV Patients any Relationship?

Abstract

Background: Tuberculosis (TB) remains an important communicable disease all over the world. The serum protein levels in TB patients may be altered by low immunity, edema and decrease antioxidant activity. This study therefore evaluates the relationship between TB and serum proteins with emphasis on albumin/globulin ratio an important component for treatment and management of TB. The study also aimed at comparing albumin/globulin ratio of tuberculosis patients, HIV patients, those on drugs and naive patients. Materials and Method: A total of 120 participants (42 control and 78 patients) aged between 15 years-65 years and sex-matched attending Plateau State Specialist Hospital were enrolled. Total protein was estimated using Biuret method and albumin by Bromocresol green method, serum globulin value was obtained by subtracting albumin from total protein then albumin/globulin ratio was calculated. Screening for HIV antibody was done using Determine strip and confirmed with Unigold. Results: Evaluated albumin/globulin ratio (1:4) was obtained in the TB case when compared to control group (p = 0.002). The albumin was significantly higher in study group compared to control (2.95 ± 0.86 and 2.75 ± 0.65 g/dl) while total protein and globulin was significantly lower (6.17 ± 1.66 and 6.76 ± 0.86 g/dl, p = 0.011 and 3.22 ± 1.9 and 3.97 ± 0.86 g/dl with p = 0.016. Patients seropositive for HIV antibody had a decrease in serum total protein, albumin and globulin but high albumin/globulin ratio. Total protein, albumin, globulin and albumin/globulin of TB patients not on drugs were elevated compared to those currently undergoing treatment. Age group < 30 years when compared with age group between 30-40 years showed significant low albumin and albumin/globulin ratio (2.74 ± 0.75 and 3.10 ± 0.72 g/dl, p = 0.025 and 0.97:1 ± 0.66and 1.42:1 ± 1.47, p = 0.042). Conclusion: Our work suggests that individuals < 30 years had hypoproteinaemia which maybe lead to low immunity. Our results also suggests that albumin/globulin ratio of TB patients on drugs were higher which may be due to hyperalbunaemia observed in this group. For effective treatment and management of TB infected individuals, appropriate use of drugs, adherence to treatment plan, close monitoring of dietary intake is needful in building and improving immunity.