Abstract: - Tuberculosis treatment with isoniazid, rifampicin, pyrazinamide, and ethambutol achieves high cure rates but carries hepatotoxicity risks (2-28% globally) and nephrotoxicity, necessitating biochemical monitoring. C-reactive protein (CRP) has emerged as a potential treatment response biomarker, yet longitudinal data from sub-Saharan Africa remain limited. This study characterized biomarker evolution during standard anti-TB treatment in Cameroon. Prospective cohort study of 45 HIV-negative pulmonary TB patients at Jamot Hospital, Yaoundé (March 2023–September 2025). Participants received WHO-recommended 2HRZE/4HR regimen. CRP, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, and blood urea nitrogen were measured at baseline (M0), month 2 (M2), and month 6 (M6). Friedman test with Bonferroni- corrected post-hoc comparisons evaluated longitudinal changes. All 45 patients completed treatment; 95.6% achieved microbiological cure. Median CRP declined 50% from baseline to treatment completion (48→24 mg/L), with no change during intensive phase (M0-M2) but significant reduction during continuation phase (M2-M6, p100 U/L); median ALT decreased 31% (26→18 U/L). AST/ALT ratio increased progressively (0.75→1.51), indicating mild rifampicin-induced enzymatic adaptation without clinical sequelae. Creatinine stability confirmed renal safety. Blood urea nitrogen exhibited marked variability, reflecting heterogeneous nutritional status. Systematic CRP monitoring at M0, M2, and M6 provides cost-effective treatment response assessment in resource-limited settings. This first Cameroonian evaluation of longitudinal CRP kinetics demonstrates feasibility of biomarker-guided TB management. Future studies should validate findings in HIV-coinfected populations.
Membangbi et al. (Wed,) studied this question.