Incomplete immunological recovery following anti-tuberculosis.

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dc.contributor.authorHanna, L E
dc.contributor.authorNayak, Kaustuv
dc.contributor.authorSubramanyam, Sudha
dc.contributor.authorVenkatesan, Perumal
dc.contributor.authorNarayanan, P R
dc.contributor.authorSwaminathan, Soumya
dc.date.accessioned2011-12-13T07:50:23Z
dc.date.available2011-12-13T07:50:23Z
dc.date.issued2009-05
dc.description.abstractBackground & objectives: Mycobacterium tuberculosis infection has been shown to result in increased HIV replication and disease progression in HIV-infected individuals through increased immune activation. The objective of this study was to correlate plasma levels of immune activation markers with the presence of tuberculosis (TB) in HIV-infected and uninfected individuals, and to study the changes following anti-tuberculosis treatment. Methods: Plasma markers of immune activation - neopterin, beta-2-microglobulin (β2M) and soluble tumour necrosis factor alpha receptor type I (sTNFα-RI) were measured by ELISA in 42 HIV positive TB patients (HIV+TB+) undergoing a six-month course of TB chemotherapy. Thirty seven HIV+ persons without active TB, 38 TB patients without HIV infection, and 62 healthy volunteers served as controls. Results: Plasma levels of all three markers were elevated in HIV+ individuals, more so in those with active TB. When HIV+ individuals were further categorized based on CD4+ T cell counts, HIV+TB+ patients with CD4+ T cells counts < 200 cells/μl were found to have the highest levels at baseline with a steep fall in neopterin and sTNFα-RI during treatment, but in most instances the levels did not drop to normal. β2M levels remained persistently high despite completing TB treatment. Interpretation & conclusions: The fi ndings of the study suggest that both HIV and TB act synergistically to activate the host immune system. Although ATT was effective in clearing M. tuberculosis infection, a high proportion of HIV+ TB patients continued to have levels well above the normal range, indicating that underlying immune activation persists despite TB treatment. None of the markers were specific enough to be used to assess cure of TB.en_US
dc.identifier.citationHanna L E, Nayak Kaustuv, Subramanyam Sudha, Venkatesan Perumal, Narayanan P R, Swaminathan Soumya. Incomplete immunological recovery following anti-tuberculosis. Indian Journal of Medical Research. 2009 May; 129(5): 548-554.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/135824
dc.language.isoenen_US
dc.source.urihttps://icmr.nic.in/ijmr/2009/may/0511.pdfen_US
dc.subjectAnti-tuberculosis treatmenten_US
dc.subjectHIV-1en_US
dc.subjectimmune activationen_US
dc.subjectMycobacterium tuberculosisen_US
dc.subjectneopterinen_US
dc.subjectsTNFα-RIen_US
dc.subjectβ-2-microglobulinen_US
dc.subject.meshAcquired Immunodeficiency Syndrome --complications
dc.subject.meshAcquired Immunodeficiency Syndrome --immunology
dc.subject.meshAnalysis of Variance
dc.subject.meshBiological Markers --blood
dc.subject.meshCD4-Positive T-Lymphocytes --immunology
dc.subject.meshCell Count
dc.subject.meshEnzyme-Linked Immunosorbent Assay
dc.subject.meshEthambutol --therapeutic use
dc.subject.meshHumans
dc.subject.meshIndia
dc.subject.meshIsoniazid --therapeutic use
dc.subject.meshNeopterin --blood
dc.subject.meshPyrazinamide --therapeutic use
dc.subject.meshReceptors, Tumor Necrosis Factor, Type I --blood
dc.subject.meshRifampin --therapeutic use
dc.subject.meshTuberculosis --complications
dc.subject.meshTuberculosis --drug therapy
dc.subject.meshTuberculosis --immunology
dc.subject.meshbeta 2-Microglobulin --blood
dc.titleIncomplete immunological recovery following anti-tuberculosis.en_US
dc.typeArticleen_US
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