Sedimentation rate and suPAR in relation to disease activity and mortality in patients with tuberculosis.

To investigate how levels of the soluble urokinase plasminogen activator receptor (suPAR) and erythrocyte sedimentation rate (ESR) correlate with disease activity and prognosis in pulmonary tuberculosis (PTB). This was a retrospective analysis of patients with active PTB ( = 500) in Gondar, Ethiopia, for whom the suPAR ( = 301) and ESR ( = 330) were analysed at the start of treatment. Both biomarkers were available for 176 patients. Human immunodeficiency virus (HIV) status, chest X-ray (CXR) findings, classification according to the clinical TBscore and treatment outcome were all recorded. In a multivariable logistic regression analysis adjusted for age, sex and HIV status, surrogate markers of disease activity such as advanced CXR patterns correlated with increased levels of suPAR (adjusted OR [aOR] 8.24, < 0.001) and of ESR (aOR 1.63, = 0.030), whereas ESR only correlated significantly with a TBscore >6 points. Increased levels of both suPAR and ESR were associated with unsuccessful treatment outcomes (aOR 2.93, = 0.013; aOR 2.52, = 0.025). The highest quartile of suPAR (aOR 13.3, = 0.029) but not ESR levels correlated independently with increased mortality. SuPAR and ESR levels correlate with disease activity in PTB; however, the clinical role of these potentially prognostic biomarkers needs to be verified in prospective studies.