Frequency of Positive Antinuclear Antibody in People With Active Tuberculosis and Its Changes With Antitubercular Therapy

Background Tuberculosis (TB), one of the most prevalent chronic infectious diseases in our country, can disrupt immune function and induce autoantibodies such as antinuclear antibodies (ANAs). As ANA positivity occurs in both TB and autoimmune diseases such as systemic lupus erythematosus (SLE), it can complicate the diagnosis when symptoms overlap. Furthermore, it remains unclear whether ANA positivity resolves with successful TB treatment. This study aimed to assess the prevalence of ANA in active TB patients and evaluate changes in ANA status following anti-TB therapy. Methods This prospective observational study was conducted at the Bangabandhu Sheikh Mujib Medical University (BSMMU) and included 150 adult patients (≥18 years) with newly diagnosed active tuberculosis and no history of autoimmune diseases. ANA testing was performed at baseline, and repeat ANA testing was conducted after three and six months of anti-TB therapy. Qualitative data were summarised as numbers and percentages, with chi-square, t-test, and Mann-Whitney U applied as appropriate. Results A total of 13 out of 150 patients (8.7%) with active tuberculosis tested positive for ANAs. Among the 53 patients with pulmonary TB, six (11.3%) were ANA positive, while seven out of 97 patients (7.2%) with extrapulmonary TB tested ANA positive. The most common ANA pattern observed was the coarse speckled pattern, found in nine of the 13 ANA-positive patients (69.23%). After six months of antitubercular therapy, 12 out of the 13 initially ANA-positive patients (92.3%) became ANA negative. Conclusion Positive ANA antibodies were detected in pulmonary TB patients as well as in extrapulmonary TB patients. However, no significant associations were found between antinuclear antibodies and active tuberculosis.