ABSTRACT
Characterizing perturbations in the immune response to tuberculosis in HIV can develop insights into the pathogenesis of coinfection. HIV+ TB+ and TB monoinfected (TB+) subjects recruited from clinics in Bamako prior to initiation of TB treatment were evaluated at time-points following initiation of therapy. Flow cytometry assessed CD4+/CD8+ T cell subsets and activation markers CD38/HLA-DR. Antigen specific responses to TB proteins were assessed by intracellular cytokine detection and proliferation. HIV+ TB+ subjects had significantly higher markers of immune activation in the CD4+ and CD8+ T cells compared to TB+ subjects. HIV+ TB+ had lower numbers of TB-specific CD4+ T cells at baseline. Plasma IFNγ levels were similar between HIV+ TB+ and TB+ subjects. No differences were observed in in-vitro proliferative capacity to TB antigens between HIV+ TB+ and TB+ subjects. Subjects with HIV+ TB+ coinfection demonstrate in vivo expansion of TB-specific CD4+ T cells. Immunodeficiency associated with CD4+ T cell depletion may be less significant compared to immunosuppression associated with HIV viremia or untreated TB infection.
Subject(s)
CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Coinfection/immunology , HIV Infections/immunology , Tuberculosis, Pulmonary/immunology , ADP-ribosyl Cyclase 1/immunology , Adult , Anti-HIV Agents/therapeutic use , Antigens, Bacterial/immunology , Antitubercular Agents/therapeutic use , Cell Proliferation , Coinfection/drug therapy , Female , Flow Cytometry , HIV Infections/drug therapy , HLA-DR Antigens/immunology , Humans , Interferon-gamma/immunology , Interleukin-10/immunology , Interleukin-12/immunology , Interleukin-13/immunology , Interleukin-2/immunology , Lymphocyte Activation/immunology , Male , Tuberculosis, Pulmonary/drug therapy , Tumor Necrosis Factor-alpha/immunologyABSTRACT
Cette etude decrit les infirmites lepreuses observees chez les 275 nouveaux patients de l'essai multicentrique; OMS/THMYEC des regions combines associant l'oflaxacine rifampicine dans le traitement de la lepre; au moment de l'inclusion. Cet essai a debute en octobre 1992 et a ete realise dans la region de Koulikoro au Mali. Sur les 275 inclus 76 (26;7 pour cent) etaient porteurs d'infirmites au depistage dont 40 (14;5 pour cent) de degre 2. La repartition de ses infirmites a montre une predominance masculine 47 cas (33;8 pour cent p=0.02); une predominance dans la forme MB 36 cas (43;9 pour cent p=0.01) et une augmentation en fonction de l'age de 21 cas (20;6 pour cent) chez les sujets jeunes a 30 cas (41;7 pour cent) chez les sujets ages (p=0.01)
Subject(s)
Leprosy/complicationsABSTRACT
Le clone III-1 de Neisseria meningitidis sérogroupe A était inconnu en Afrique jusqu'en 1988. Depuis cette date; nous assistons à une vague épidémique secouant la plupart des pays de l'Afrique centrale et de l'Afrique de l'Est. Nous avons montré une étude des protéines de membrane externe; que la souche de méningocoque responsable de l'épidémie du Mali depuis 1994 est le clone III-I
