Association of Plasma Matrix Metalloproteinase and Tissue Inhibitors of Matrix Metalloproteinase Levels With Adverse Treatment Outcomes Among Patients With Pulmonary Tuberculosis

Abstract

India accounts for 26% of all cases of tuberculosis (TB) worldwide and ranks as the No. 1 country for TB burden.¹ The World Health Organization and the Indian government have set ambitious goals for the elimination of TB.^2,3 However, to achieve this goal, new studies are needed, including studies to identify biomarkers of treatment response.⁴ A 6-month regimen of 4 drugs (4 drugs in the first 2 months and 2 drugs in the next 4 months) is the standard of care for drug-susceptible pulmonary TB (PTB) based on the need to achieve low recurrence rates, yet less than 20% of patients with TB are expected to be at increased risk for recurrence if treatment shortening to 4 months or less is implemented.⁵ Treatment shortening would greatly aid in the progress toward elimination of TB by promoting adherence, favoring better case management and disease control, minimizing the risk of acquired drug resistance, and lowering the operational burden on national programs.^6,7 Thus, the need to identify biomarkers of cure that could allow stratification of patients at risk for adverse treatment outcomes is urgent.⁴