Prognostic value of sputum HMGB1 in smear-negative and smear-positive pulmonary TB
Issued Date
2026-02-27
Resource Type
eISSN
18157920
Scopus ID
2-s2.0-105031717286
Pubmed ID
41761393
Journal Title
International Journal of Tuberculosis and Lung Disease the Official Journal of the International Union Against Tuberculosis and Lung Disease
Volume
30
Issue
3
Start Page
100
End Page
106
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Tuberculosis and Lung Disease the Official Journal of the International Union Against Tuberculosis and Lung Disease Vol.30 No.3 (2026) , 100-106
Suggested Citation
Kamolratanakul S., Bhunyakarnjanarat T., Ariyanon W., Wilairatana P., Leelahavanichkul A., Chancharoenthana W. Prognostic value of sputum HMGB1 in smear-negative and smear-positive pulmonary TB. International Journal of Tuberculosis and Lung Disease the Official Journal of the International Union Against Tuberculosis and Lung Disease Vol.30 No.3 (2026) , 100-106. 106. doi:10.5588/ijtld.25.0186 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115622
Title
Prognostic value of sputum HMGB1 in smear-negative and smear-positive pulmonary TB
Corresponding Author(s)
Other Contributor(s)
Abstract
<sec><title>BACKGROUND</title>Diagnosing pulmonary TB (PTB) in patients with negative sputum acid-fast bacillus (AFB) staining is challenging and impedes transmission control. This study assessed the prognostic utility of sputum high-mobility group box protein 1 (HMGB1) in PTB, focusing on treatment outcomes.</sec><sec><title>METHODS</title>In a prospective cohort study, we enrolled 66 PTB patients: 37 smear-positive (MTB-MC) and 29 smear-negative but clinically suspected (MTB-SN), confirmed by bacteriology or treatment response. All underwent GeneXpert MTB/RIF testing. Sputum HMGB1 levels were measured at baseline, 2 months, and 6 months post-treatment.</sec><sec><title>RESULTS</title>Of the 66 participants, 37 had bacteriologically confirmed PTB (MTB-MC) with AFB grades ranging from scanty (n = 6) to 3+ (n = 12), and 29 had smear-negative PTB (MTB-SN). Sputum HMGB1 levels declined significantly during treatment (P < 0.001). Baseline HMGB1 strongly correlated with bacillary load (r2 = 0.4645, P < 0.0001). Notably, 2-month HMGB1 levels predicted culture conversion, with an area under the curve of 0.885 for treatment failure in the MTB-MC group.</sec><sec><title>CONCLUSION</title>Sputum HMGB1 is a promising marker for monitoring treatment response and predicting failure in PTB, especially in smear-negative cases. Despite limited diagnostic specificity due to elevation in inflammatory conditions, its role in assessing 2-month culture conversion warrants further study. Larger studies are needed to validate clinical thresholds.</sec>.