Hepatic Steatosis affects the Outcome of Anti- tuberculosis Treatment in Pulmonary Tuberculosis Patients

Abstract Background: Pulmonary Tuberculosis (PTB) remains the leading cause of death from infectious diseases worldwide. Few studies have investigated hepatic steatosis's effect on PTB's progression and prognosis. Methods: We selected 785 PTB patients in this study. And 174 PTB patients were enrolled in the statistical analysis. Patients with positive sputum smears for over eight weeks are clustered in the Extension Group. Conversely, the other patients are clustered in the Unextended Group. The clinical data were used to analyze the risk factors for the time of smear conversion. Results: Eleven different factors were obtained from the clinical data of PTB patients. According to clinical significance, correlation detection, collinearity diagnosis, and chest package score, six factors were enrolled into the model. The logistics regression analysis confirmed that Hepatic steatosis and IL-18 were positively correlated with the smear conversion (β= 2.401, OR =11.036, 95% CI = 2.489-48.934; β= 2.396, OR =10.984, 95% CI = 1.832-65.862). On the contrary, the T-SPOT was negatively correlated with the smear conversion (β= -4.199, OR =0.015, 95% CI = 0.001-0.172). Conclusions: Hepatic steatosis is confirmed as an independent risk factor affecting smear conversion time in PTB. The levels of serum cytokines, such as IL-6 and IL-18, are significantly related to the outcome of anti-tuberculosis treatment. Previous studies have confirmed that hepatic steatosis is associated with abnormal serum cytokines. Therefore, more attention is needed for the PTB patients with hepatic steatosis.