Sustained plasma TNF-α and HIV-1 load despite resolution of other parameters of immune activation during treatment of tuberculosis in Africans

Stephen D. Lawn, Robin J. Shattock, Joseph W. Acheampong, Renu B. Lal, Thomas M. Folks, George E. Griffin, Salvatore T. Butera

    Research output: Contribution to journalArticlepeer-review

    65 Scopus citations


    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 languageEnglish (US)
    Pages (from-to)2231-2237
    Number of pages7
    Issue number16
    StatePublished - Jan 1 1999


    • Africa
    • HIV-1 load
    • Immune activation
    • Opportunistic infection
    • Tuberculosis
    • Tumour necrosis factor-α

    ASJC Scopus subject areas

    • Immunology and Allergy
    • Immunology
    • Infectious Diseases


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