期刊
JOURNAL OF INFECTIOUS DISEASES
卷 203, 期 7, 页码 992-1001出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiq141
关键词
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资金
- National Institutes of Health [AI079847-01, AI051219, T32 HL07889]
- Rainbow Babies and Children's Hospital
- Center for AIDS Research Developmental
- [HHSN266200700022C/NO1-AI-70022]
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/mm(3) 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-gamma 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/mm(3), 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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