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Purpose: To analyze the causal relationship between 486 human serum metabolites and the active tuberculosis (ATB) in European population. Methods: In this study, the causal relationship between human serum metabolites and the ATB was analyzed by integrating the genome-wide association study (GWAS). The 486 human serum metabolites were used as the exposure variable, three different ATB GWAS databases in the European population were set as outcome variables, and single nucleotide polymorphisms were used as instrumental variables for Mendelian Randomization. The inverse variance weighting was estimated causality, the MR-Egger intercept to estimate horizontal pleiotropy, and the combined effects of metabolites were also considered in the meta-analysis. Furthermore, the web-based MetaboAnalyst 6.0 was engaged for enrichment pathway analysis, while R (version 4.3.2) software and Review Manager 5.3 were employed for statistical analysis. Results: A total of 21, 17, and 19 metabolites strongly associated with ATB were found in the three databases after preliminary screening (P < 0.05). The intersecting metabolites across these databases included tryptophan, betaine, 1-linoleoylglycerol (1-monolinolein) (1-LG), 1-eicosatrienoylglycerophosphocholine, and oleoylcarnitine. Among them, betaine (I2 = 24%, P = 0.27) and 1-LG (I2 = 0%, P = 0.62) showed the lowest heterogeneity among the different ATB databases. In addition, the metabolic pathways of phosphatidylethanolamine biosynthesis (P = 0.0068), methionine metabolism (P = 0.0089), betaine metabolism (P = 0.0205) and oxidation of branched-chain fatty acids (P = 0.0309) were also associated with ATB. Conclusion: Betaine and 1-LG may be biomarkers or auxiliary diagnostic tools for ATB. They may provide new guidance for medical practice in the early diagnosis and surveillance of ATB. In addition, by interfering with phosphatidylethanolamine biosynthesis, methionine metabolism, betaine metabolism, oxidation of branched-chain fatty acids, and other pathways, it is helpful to develop new anti-tuberculosis drugs and explore the virulence or pathogenesis of ATB at a deeper level, providing an effective reference for future studies. [ABSTRACT FROM AUTHOR]

Objective: To understand the effect of antiretroviral therapy (ART) in reducing deaths among patients co-infected with Mycobacterium tuberculosis and human immunodeficiency virus (TB/HIV), and provide data-based evidence for improving ART in TB/HIV patients., Methods: The information about TB patients who were HIV positive confirmed previously or recently in Guangxi were collected, and the TB/HIV patients were confirmed by using the related data from national AIDS prevention and treatment information system. Then a retrospective case control study was conducted to understand the survivals and deaths in the patients receiving ART or receiving no ART by using Kaplan-Meier method and estimate the ART protective rate within 1 year after TB treatment initiation., Results: Among 519 TB/HIV patients, 100 received ART (19.3%); Among 84 TB/HIV patients who died within 1 year after TB treatment, 8 (9.5%) received ART, while 76 (90.5%) received no ART. Compared with the 18.7% mortality rate in non-ART group, TB/HIV patients mortality rate in ART group was only 8.08%, the difference was statistical significant (P < 0.05). Kaplan-Meier survival curve showed that the survival rate in patients receiving ART was higher than that in patients receiving no ART within 1 year after TB treatment, the difference was statistical significant (Log-rank = 4.96, P = 0.02). Compared with patients receiving ART, the OR value was 2.31 times higher than that in patients receiving no ART;ART could protect 56.7% of TB/HIV patients against death during the first year of anti-TB therapy., Conclusion: In the first year of anti-TB therapy, the risk of death in TB/HIV patients receiving no ART was much higher than that in TB/HIV patients receiving ART, and the survival time was longer in the patients receiving ART. The ART coverage should be expanded in TB/HIV patients.

Objective: To understand the general feature of patients with Mycobacterium tuberculosis (MTB) and human immunodeficiency virus (HIV) co-infectious (TB/HIV) in Guangxi, from 2007 to 2012., Methods: Information regarding individuals that the contributory causes of death were due to MTB infection among HIV as the underlying cause of death from the Vital Registration System, together with bacterium smear or culture results, onset of TB, time that TB was diagnosed and entered an Internet base TB surveillance system was collected and checked. Data including information on time of death, age, occupation, the underlying cause of death among TB patients, bacterium distribution, average age of death, interval from onset to death, percentage of TB/HIV co-infection patients among all the patients etc, were all analysed., Results: 203 patients died from HIV associated with TB from the Guangxi Vital Registration System were identified between 2007 and 2012. The average percentage of TB/HIV co-infection cases accounted for 8.24% (ranging from 3.94% in 2007 to 13.27% in 2012) among all the deaths of HIV infection while it accounted for 9.90% (ranging from 2.56% to in 2007 to 26.88% in 2012) among patients with MTB infection in the same period. The average percentage of deaths from TB/HIV co-infection in 2010 and 2012 accounted for 10.66% (ranging from 8.83% to 13.27%)and 22.17% (ranging from 20.60% to 26.88%)among patients died of HIV and TB infection respectively. The male-female ratio was 4.21 for 1, with the average age of death as 44.65 (44.65 ± 15.52) years;median time from TB symptoms onset to diagnosis as 37 (mean 94.31, standard deviation 206.07) days, record as (94.31 ± 206.07); median time from diagnosis to death as 46 (165.22 ± 282.19) days, 54.68% TB/HIV patients died within two months of being diagnosed with TB and the median time from TB symptoms onset to death as 131 (257.68 ± 340.79) days. 16.26% of the TB/HIV cases were bacterium confirmed TB cases., Conclusion: Compare to those TB patients without HIV, less bacterium evidence was found in TB/HIV patients. High burden caused by HIV disease was seen if they were co-infected with TB. An increasing proportion of deaths was noticed among patients co-infected with HIV and TB in the last three years, suggesting that the coverage of antiretroviral therapy be scaled up together with the strengthening of the capability on early TB case-finding among people live with HIV.