Affiliation:
1. Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
2. Department of Dermatology and Venerology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
3. Department of Viroscience, Erasmus University Medical Center, Rotterdam, The Netherlands
4. Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
Abstract
Abstract
Background
Leprosy is a chronic infectious disease that can lead to severe lifelong disabilities. Close contacts of patients with leprosy have a higher risk of acquiring the disease. Nevertheless, there is a lack of reliable markers to predict Mycobacterium leprae infection. We aimed to identify new potential markers for developing clinical leprosy among contacts.
Methods
Serum levels of interleukin (IL) 6, IL-8, IL-10, hemoglobin, ferritin, and transferrin saturation were measured in 67 patients with multibacillary leprosy (MB), 65 household contacts (HHCs) of MB patients, and 127 endemic controls (ECs). By means of multivariate logistic regression and receiver operating characteristic (ROC) analyses, we analyzed baseline variables and laboratory parameters that showed significant differences between MB in the HHC and EC groups and obtained the respective areas under the curve (AUC). Optimal cutoff values of the associated cytokines were also determined.
Results
Elevated IL-6 level was observed in MB patients compared to HHCs and ECs (P = .022 and .0041, respectively). Anemia and iron deficiency were also higher in the MB group compared to HHCs or ECs (P < .001). Likewise, we observed an increased risk of having MB leprosy in underweight HHCs (odds ratio [OR], 2.599 [95% confidence interval {CI}, .991–6.820]) and underweight ECs (OR, 2.176 [95% CI, 1.010–4.692]). Further ROC analysis showed that high serum IL-6 level, underweight, anemia, and iron deficiency can discriminate leprosy from their HHCs (AUC, 0.843 [95% CI, .771–.914]; P = .000; optimal cutoff value of IL-6 = 9.14 pg/mL).
Conclusions
Our results suggest that serum IL-6 and nutrition status could serve as potential prognostic markers for the development of clinical leprosy in infected individuals.
Funder
Indonesian Endowment Fund for Education
Ministry of Finance of the Republic of Indonesia
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
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