URINARY NEOPTERIN A SURROGATE MARKER OF ACTIVE TUBERCULOSIS AND ASSESMENT OF TREATMENT OUTCOME

Background- There are several advancements in the diagnostic tests of tuberculosis but obtaining material from nonproductive pulmonary  as well as extrapulmonary cases still remains a challenge. This prompted us to search for a non invasive marker to diagnose active TB. Methods- Total 100 subjects   were enrolled  in study. Categorization of patients  into active, LTBI and control done with the help of Mantoux test, IGRA, smear microscopy and CBNAAT. 10 to 15 ml spot urine sample from all the subjects was collected in sterile container and sent to pathology lab  for the estimation  of  neopterin level in urine  by  ELISA method determined by optical density. Patients having active disease antitubercular  treatment started after doing baseline urinary nepoterin test and follow up  test was  also done at the end of 3 month and 6 month ( end of treatment). Results- Our study compare the urinary neopterin value between  active TB, latent TB and normal subjects. It was found that there was statistically significant difference in the base line urinary neopterin level among active cases , LTBI  and control. Among active TB cases after the initiation of standard first line anti tubercular treatment  follow up urinary neopterin test was also done at 3 months and at 6 months. Comparing urinary neopterin  from base line to 3 month and at 6 month it was found statistically significant ( p value<0.05). Further more on comparison of urinary neopterine  at 3 month and 6 month it was statistically insignificant (p value >0.05). Conclusion-Urinary neopterin can be considered as a surrogate marker to diagnose active TB and treatment outcome.