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Kinetics of Mycobacterium tuberculosis-specific IFN-γ responses and sputum bacillary clearance in HIV-infected adults during treatment of pulmonary tuberculosis

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Author(s)

David T. Mzinza, Derek James Sloan, Kondwani C. Jambo, Doris Shani, Mercy Kamdolozi, Katalin A. Wilkinson, Robert J. Wilkinson, Geraint R. Davies, Robert S. Heyderman, Henry C. Mwandumba

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Abstract

In HIV-uninfected adults with pulmonary tuberculosis (TB), anti-TB treatment is associated with changes in Mycobacterium tuberculosis (Mtb)-specific immune responses, which correlate with sputum bacillary load. It is unclear if this occurs in HIV-infected TB patients. We investigated changes in Mtb-specific immune responses and sputum bacillary clearance during anti-TB treatment in HIV-infected and HIV-uninfected adults with pulmonary TB. Sputum bacillary load was assessed by smear microscopy and culture. Mtb-specific IFN-γ secreting peripheral blood mononuclear cells were enumerated using an ELISPOT assay following stimulation with PPD, ESAT-6 and CFP-10. The baseline frequency of Mtb-specific IFN-γ secreting cells was lower in HIV-infected than HIV-uninfected patients (median PPD 32 vs. 104 Spot Forming Units (SFU), p = 0.05; CFP-10 19 vs. 74 SFU, p = 0.01). ESAT-6-specific IFN-γ secreting cells and sputum bacillary load declined progressively during treatment in both HIV-infected and HIV-uninfected patients. HIV infection did not influence the 2-month sputum culture conversion rate (Odds Ratio 0.89, p = 0.95). These findings suggest that changes in ESAT-6-specific immune responses during anti-TB treatment correspond with changes in sputum bacillary load irrespective of host HIV infection status. The utility of Mtb-specific IFN-γ responses as a proxy measure of treatment response in HIV-infected TB patients warrants further evaluation in other settings.

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Details

Original languageEnglish
Article number1343
Pages (from-to)463-469
Number of pages7
JournalTuberculosis
Volume95
Issue number4
Early online date28 May 2015
DOIs
Publication statusPublished - 1 Jul 2015

    Research areas

  • Mycobacterium tuberculosis, Antigen-specific immunity, IFN-γ, Pulmonary tuberculosis, HIV infection, Anti-tuberculosis treatment

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