Abstract
Objective: To determine the impact of treatment of tuberculosis on plasma HIV-1 load in African subjects and to correlate viral load with response to treatment and changes in immune activation. Design: Clinical and microbiological responses, immune activation parameters and plasma HIV-1 load were determined in 20 patients with pulmonary tuberculosis and HIV-1 coinfection in Ghana, West Africa during the first 3 months of antituberculosis treatment. Methods: Plasma HIV-1 load and markers of immune activation were determined by commercially available assays. Human leukocyte antigen (HLA)-DR incorporation into the HIV-1 envelope was measured by using an immunomagnetic capture technique. Results: Treatment of tuberculosis resulted in significant improvements in weight and haemoglobin, a high sputum smear conversion rate and marked reductions in mean plasma tumour necrosis factor (TNF) receptor-1, interleukin-6 and C-reactive protein. Furthermore, incorporation of host HLA-DR into the HIV-1 envelope decreased; this also suggested a reduction in immune activation of the cells supporting viral replication. However, of importance with regard to AIDS pathogenesis, neither mean plasma TNF-α nor HIV-1 load decreased significantly. Conclusions: The failure of HIV-1 plasma load to decline significantly during the initial months of anti-tuberculosis treatment is associated with high, sustained systemic levels of TNF-α. The dissociation between the sustained levels of plasma TNF-α and the major reductions in other, diverse immune activation parameters may represent dysregulation of cytokine production in these African patients.
Original language | English (US) |
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Pages (from-to) | 2231-2237 |
Number of pages | 7 |
Journal | AIDS |
Volume | 13 |
Issue number | 16 |
DOIs | |
State | Published - Jan 1 1999 |
Keywords
- Africa
- HIV-1 load
- Immune activation
- Opportunistic infection
- Tuberculosis
- Tumour necrosis factor-α
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Infectious Diseases