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A progress of tuberculosis and HIV/tuberculosis treatment assessed by fingerprinting of small molecule-biomarkers in patients from Eastern Europe (TB prognosis)
Start date: Apr 1, 2013, End date: Mar 31, 2017 PROJECT  FINISHED 

A dramatically high incidence of multidrug-resistant (MDR) and extended drug resistant (XDR) tuberculosis (TB) was reported in WHO European Region. Countries in Eastern Europe still fail to control TB and in, for example, Ukraine, a number of new TB cases is as high as 100-299 per 100 000 (data for 2010). TB is often accompanied by HIV on this territory. In EU countries, patients with MDR and XDR-TB recover with the efficiency of only 32%. For successful control of TB, quick diagnosis is among most important factors. In low-income countries, TB diagnostics is restricted mainly to clinical manifestations and sputum smear microscopy. TB clinical symptoms are often obscured in HIV positive individuals and sputum smear test detects only up to 60% of TB cases. Modern more efficient methods are not affordable. Furthermore, there are few tools to judge the efficiency of a certain therapy in already confirmed TB cases. We hypothesize that cheaper and quicker detection of TB is possible as well as assessment of the treatment progress over the time. It could be done through measurement of small molecule biomarkers in body fluids of the patients. A network has been created between Umea University, Sweden, Metchnikov’s University/TB Clinics, Ukraine and University Hospital Germans Trias i Pujol, Spain that has access to a modern metabolomics facility and an extensive work experience with TB and chemical analysis of biomedical samples. We propose to collect samples from Ukrainian TB and HIV/TB patients under treatment and analyze them with several chromatographic methods in order to detect relevant biomarkers. We plan also to genotype M.tuberculosis isolates from these patients, monitor possible antibiotic resistance development and evaluate the host response. An array of these methods will help to get a detailed and dynamic clinical description of the cases and assign certain small molecules levels to respective events during treatment of TB, MDR-TB and HIV/TB co-infection.

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