The Association of Monocyte Lymphocyte Ratio and IFN-γ/ IL-4 Ratio on Status of Sputum Conversion in Tuberculosis Patients with Post Intensive Phase

Abstract

Background: Conversion status post-intensive phase of treatment in patients with tuberculosis
(TB) is an important thing in determining the choice of the next treatment plan. Alternative
parameters need to be studied to determine the factors that contribute to this status. Potential
parameters thought to have a role are Monocyte Lymphocyte Ratio (MLR) as a hematological
marker and Interferon Gamma/Interleukin-4 (IFN-γ/IL-4) as a molecular marker of cytokines and
chemokines. Objective: analyzed the association between MLR and IFN-γ/IL-4 ratio on status of
sputum conversion in TB patients with post-intensive phase. Method: The design of this study was
cross-sectional with consecutive sampling, which was conducted in the period March to July 2021.
The data used in this study included MLR, IFN-g /IL-4 ratio, and sputum smear conversion. The
statistical tests used included chi-square, fisher’s exact test, and logistic regression with p < 0.05.
Result: Low MLR (98.2%) and high MLR (55.6%) scores, both had positive sputum conversion
(OR = 44.8; CI 4.169 – 481.452; p = 0.001). Meanwhile, the positive sputum conversion showed
low IFN-γ/IL-4 ratio (97.8%) and high IFN-γ/IL-4 ratio (80%; OR = 11.25; CI 1.169 – 108.280; p =
0.036). There was a significant association between low MLR and sputum conversion positive (OR
= 27.103; CI 2.289 – 320.883; p = 0.009). Meanwhile, IFN-γ/IL-4 ratio and sputum conversion did
not have a significant association (OR = 5.248; CI 0.414 – 66,454; p = 0.201). Conclusion: there is
a significant association between MLR, IFN-γ/IL-4 ratio, and the combination of MLR and IFN-γ/
IL-4 ratio on sputum conversion in TB patients with post-intensive phase.