TY - JOUR
T1 - Effects of antiretroviral therapy on immune function of HIV-infected adults with pulmonary tuberculosis and CD4+ >350 cells/mm3
AU - Lancioni, Christina L.
AU - Mahan, C. Scott
AU - Johnson, Denise F.
AU - Walusimbi, Maria
AU - Chervenak, Keith A.
AU - Nalukwago, Sophie
AU - Charlebois, Edwin
AU - Havlir, Diane
AU - Mayanja-Kizza, Harriet
AU - Whalen, Christopher C.
AU - Boom, W. Henry
N1 - Funding Information:
This work was supported by the National Institutes of Health (grants AI079847-01 to C.L., AI051219 to C.W., and T32 HL07889 to C.S.M.); the Rainbow Babies and Children’s Hospital Fellowship Research Award (to C.L.); the Center for AIDS Research Developmental Pilot Grant Award (to C.S.M.); and grant HHSN266200700022C/NO1-AI-70022 for the Tuberculosis Research Unit (to W.H.B.).
PY - 2011/4/1
Y1 - 2011/4/1
N2 - 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.
AB - 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.
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U2 - 10.1093/infdis/jiq141
DO - 10.1093/infdis/jiq141
M3 - Article
C2 - 21402550
AN - SCOPUS:79952995738
SN - 0022-1899
VL - 203
SP - 992
EP - 1001
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 7
ER -