Mycobacterium tuberculosis infection continues to be a major global challenge. All patients with pulmonary tuberculosis are treated with a standard 6-month treatment regimen. Historical data suggest that even with shortened treatment, most patients achieve long-term remission. Risk stratification is a goal for reducing potentially toxic prolonged treatment. This study aimed to determine the factors associated with the early clearance of sputum acid-fast bacilli (AFB). A total of 297 freshly diagnosed patients with pulmonary tuberculosis were included and enrolled in this study. Information related to their ethno-demographic and anthropometric characteristics was collected. We also assessed their complete blood counts, and blood iron, folate, and vitamin B12 levels. We found that the presence of higher levels of acid-fast bacilli (AFB) in diagnostic sputum microscopy was the single most significant prognostic factor associated with early clearance of sputum AFB after 2 months of treatment. All of our patients achieved treatment success after 6 months of treatment and were disease free. Our results support the data obtained from previous studies indicating that AFB clearance at 2 months is unlikely to be a clinically useful biomarker or indicator for therapeutic stratification. Furthermore, demographic, anthropometric, and nutritional factors are not clinically useful biomarkers.

中文翻译：

---

一组巴基斯坦肺结核患者治疗 2 个月时反应的决定因素

结核分枝杆菌感染仍然是一项重大的全球挑战。所有肺结核患者均接受标准的 6 个月治疗方案。历史数据表明，即使缩短治疗时间，大多数患者仍能获得长期缓解。风险分层是减少潜在毒性长期治疗的目标。本研究旨在确定与痰抗酸杆菌（AFB）早期清除相关的因素。共有 297 名新诊断的肺结核患者被纳入本研究。收集了与其民族人口学和人体测量学特征相关的信息。我们还评估了他们的全血细胞计数、血铁、叶酸和维生素 B12 水平。我们发现诊断性痰镜检查中抗酸杆菌 (AFB) 水平较高是与治疗 2 个月后痰 AFB 早期清除相关的最重要的预后因素。我们所有的患者在治疗 6 个月后都取得了治疗成功，并且没有疾病。我们的结果支持从先前研究获得的数据，表明 2 个月时 AFB 清除不太可能成为临床有用的生物标志物或治疗分层的指标。此外，人口统计学、人体测量学和营养因素不是临床有用的生物标志物。我们所有的患者在治疗 6 个月后都取得了治疗成功，并且没有疾病。我们的结果支持从先前研究获得的数据，表明 2 个月时 AFB 清除不太可能成为临床有用的生物标志物或治疗分层的指标。此外，人口统计学、人体测量学和营养因素不是临床有用的生物标志物。我们所有的患者在治疗 6 个月后都取得了治疗成功，并且没有疾病。我们的结果支持从先前研究获得的数据，表明 2 个月时 AFB 清除不太可能成为临床有用的生物标志物或治疗分层的指标。此外，人口统计学、人体测量学和营养因素不是临床有用的生物标志物。