ABSTRACT
The effect of intestinal helminthes [IH] and Toxoplasma gondii [Tox] coinfection on anti-mycobacterium tuberculosis [MTB] immunity in patients with active pulmonary tuberculosis was studied in 96 patients of 4 groups. Thirteen patients had TB+IH+Tox [Gl], 15 had TB+IH [G2], 21 had TB+Tox [G3] and 47 had TB [G4]. The mean diameter of tuberculin and toxoplasmin tests was measured to assess cell mediated immunity. Anti-Toxoplasma IgG[1] and IgG[4] antibodies were sought in toxoplasmic patients by EL1SA for Thelper[1] [Th[1]] and Th[2] cytokine responses respectively. All patients were treated by 6 months anti-MTB therapy. Specific anti-IH therapies were given for patients with concomitant IH. Sputum examination for acid fast bacilli was done 2 weeks post-treatment and duration of sputum clearance was recorded. The results showed that IH co-infection had significant negative effect on mean diameter of tuberculin test compared to.G4 [5.87 +/- 0.08 vs 8.65 +/- 0.05mm; P < 0.01]. Concurrent Tox with TB significantly increased tuberculin test mean diameter [10.89 +/- 0.11 vs 8.65 +/- 0.05mm; P < 0.05]. Mean level of anti-Tox IgG[1] among G3 was significantly higher than in Gl [0.88 +/- 0.05vs0.55 +/- 0.02; P < 0.001], but vice versa was with IgG[4]. Mean tuberculin diameter increased significantly post-treatment in all Gs except G3. Anti-Tox IgG[1] showed significant increase [0.55 +/- 10.02 to 0.82 +/- 0.03; P < 0.001] but IgG[4] showed significant decrease [0.62 +/- 0.07 to 0.45 +/- 0.06, P < 0.01] post-treatment in Gl, but G3 was insignificantly affected. The duration of sputum clearance was significantly longer in patients with IH co-infection compared to G4 [29 +/- 1 vs 21.8 +/- 4.6, days p < 0.001]