Effects of antiretroviral therapy on immune function of HIV-infected adults with pulmonary tuberculosis and CD4+ >350 cells/mm3

Christina L. Lancioni, C. Scott Mahan, Denise F. Johnson, Maria Walusimbi, Keith A. Chervenak, Sophie Nalukwago, Edwin Charlebois, Diane Havlir, Harriet Mayanja-Kizza, Christopher C. Whalen, W. Henry Boom

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Background. Human immunodeficiency virus (HIV)-tuberculosis coinfection is associated with heightened immune activation, viral replication, and T cell dysfunction. We compared changes in T cell activation and function between patients receiving concurrent treatment for HIV-tuberculosis coinfection and those receiving treatment for tuberculosis alone. Methods. HIV-infected adults with tuberculosis and CD4+ T cell counts >350 cells/mm3 were randomized to receive tuberculosis treatment alone (control arm; n = 36) or 6 months of antiretroviral therapy (ART) concurrent with tuberculosis treatment (intervention arm; n = 38). HIV viral load, T cell subsets, T cell activation, and cytokine production were measured at enrollment and every 3 months for 12 months. Results. Differences in absolute CD4+ and CD8+ T cell counts were not observed between arms. Viral load was reduced while participants received ART; control patients maintained viral load at baseline levels. Both arms had significant reductions in T cell expression of CD38 and HLA-DR. Interferon-γ production in response to mitogen increased significantly in the intervention arm. Conclusions. In HIV-infected adults with tuberculosis and CD4+ T cell counts >350 cells/mm3, both tuberculosis treatment and concurrent HIV-tuberculosis treatment reduce T cell activation and stabilize T cell counts. Concurrent ART with tuberculosis treatment does not provide additional, sustained reductions in T cell activation among individuals with preserved immunologic function.

Original languageEnglish (US)
Pages (from-to)992-1001
Number of pages10
JournalJournal of Infectious Diseases
Volume203
Issue number7
DOIs
StatePublished - Apr 1 2011

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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