Tuberculosis Antigen-Specific T-Cell Responses During the First 6 Months of Antiretroviral Treatment

J Infect Dis. 2020 Jan 1;221(1):162-167. doi: 10.1093/infdis/jiz417.

Abstract

The reconstitution of Mycobacterium tuberculosis antigen-specific CD4 T cells in a cohort of HIV-infected persons starting antiretroviral treatment (ART) in a high tuberculosis endemic area is described. Restoration of the antigen-specific CD4 T-cell subsets mirrored the overall CD4 T-cell compartment. Activation (assessed by HLA-DR expression) decreased during ART but remained elevated compared to HIV-uninfected persons. Despite known M. tuberculosis sensitization determined by interferon-γ release assay, 12/23 participants had no M. tuberculosis-specific CD4 T cells detectable by flow cytometry, combined with overall elevated T-cell activation and memory differentiation, suggesting heightened turnover. Our data suggest early ART initiation to maintain polyfunctional immune memory responses.

Keywords: antiretroviral treatment; immune activation; immune reconstitution; protection; tuberculosis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Antigens, Bacterial / immunology
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes / immunology*
  • CD4-Positive T-Lymphocytes / metabolism
  • Female
  • Flow Cytometry
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Infections / immunology*
  • HLA-DR Antigens / metabolism
  • Humans
  • Immunologic Memory
  • Interferon-gamma Release Tests
  • Latent Tuberculosis / diagnosis
  • Latent Tuberculosis / immunology*
  • Lymphocyte Activation
  • Male
  • Mycobacterium tuberculosis / immunology*

Substances

  • Anti-HIV Agents
  • Antigens, Bacterial
  • HLA-DR Antigens