Introduction: Leukotriene A4 hydrolase (LTA4H) is an enzyme that regulates the delicate balance between Pro-Inflammatory LTB4 and Anti-inflammatory Lipoxins and directly influences susceptibility, pathogenesis and disease severity of Mycobacterium tuberculosis infection. The impact of LTA4H gene polymorphism on the disease outcome and clinical progression of PTB patients remains an understudied field, particularly in a TB endemic nation like India. We compared here the clinical, radiological, microbiological factors and treatment outcome between LTA4H genotypes: CC(Wild Type), CT, TT.

Method: We did a Prospective cohort study under the aegis of the Indo-US, TB RePORT Consortium. Clinical, radiological, microbiological and treatment outcomes (cured, death, treatment failure, relapse) were captured prospectively for consecutive patients with PTB, who consented to participate in the trial. Blood samples were collected for biomarker studies and LTA4H genotyping was performed and the subjects were categorized as CC, CT & TT alleles.

Results: In all 185 patients with a mean age of 44.6(SD-16.49), underwent genotyping. No association could be found between genotypes and clinical, radiological, microbiological features. Of the 144 patients who had outcome information 125 (86.8%) were cured and  19 (13.2%) had treatment failure/relapse. The bacteriological cure in alleles were: CC ? 90%, CT - 80%, TT - 100%, and there was no association found between the genotypes and cure (p ? 0.193).

Conclusion: We did not find any association between LTA4H genotypes and clinic-radiological, microbiological features and treatment outcomes. Larger trials may be needed to make categorical conclusions.