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Incomplete immunological recovery following anti-tuberculosis treatment in HIV-infected individuals with active tuberculosis

Hanna, L E and Nayak, Kaustuv and Subramaniyam, Sudha and Venkatesan, P and Narayanan, P R (2009) Incomplete immunological recovery following anti-tuberculosis treatment in HIV-infected individuals with active tuberculosis. Indian Journal of Medical Research, 129 (May). pp. 548-554. ISSN Print: 0971-5916; Online: 0975-9174

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Abstract

Background & objectives: Mycobacterium tuberculosis infection has been shown to result in increased HIV replication and disease progression in HIV-infected individuals through increased immune activation. The objective of this study was to correlate plasma levels of immune activation markers with the presence of tuberculosis (TB) in HIV-infected and uninfected individuals, and to study the changes following anti-tuberculosis treatment. Methods: Plasma markers of immune activation - neopterin, beta-2-microglobulin (β2M) and soluble tumour necrosis factor alpha receptor type I (sTNFα-RI) were measured by ELISA in 42 HIV positive TB patients (HIV+TB+) undergoing a six-month course of TB chemotherapy. Thirty seven HIV+ persons without active TB, 38 TB patients without HIV infection, and 62 healthy volunteers served as controls. Results: Plasma levels of all three markers were elevated in HIV+ individuals, more so in those with active TB. When HIV+ individuals were further categorized based on CD4+ T cell counts, HIV+TB+ patients with CD4+ T cells counts < 200 cells/μl were found to have the highest levels at baseline with a steep fall in neopterin and sTNFα-RI during treatment, but in most instances the levels did not drop to normal. β2M levels remained persistently high despite completing TB treatment. Interpretation & conclusions: The fi ndings of the study suggest that both HIV and TB act synergistically to activate the host immune system. Although ATT was effective in clearing M. tuberculosis infection, a high proportion of HIV+ TB patients continued to have levels well above the normal range, indicating that underlying immune activation persists despite TB treatment. None of the markers were specifi c enough to be used to assess cure of TB.

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Item Type: Article
Uncontrolled Keywords: Anti-tuberculosis treatment - HIV-1 - immune activation - Mycobacterium tuberculosis; -neopterin -sTNFα-RI -β-2-Microglobulin
Subjects: Tuberculosis > Laboratory Research > Immunological
Tuberculosis
Divisions: Basic Science Research > Immunology
Depositing User: Dr. Rathinasabapati R
Date Deposited: 13 Nov 2017 11:42
Last Modified: 13 Nov 2017 11:42
URI: http://eprints.nirt.res.in/id/eprint/952

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