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J Infect Dis. 2019 Aug 17. pii: jiz417. doi: 10.1093/infdis/jiz417. [Epub ahead of print]

Tuberculosis antigen-specific T cell responses during the first 6 months of antiretroviral treatment.

Riou C1,2,3, Jhilmeet N1,3, Rangaka MX3, Wilkinson RJ1,4,3,5,6, Wilkinson KA1,4,3,6.

Author information

1
Wellcome Center for Infectious Disease Research in Africa.
2
Division of Medical Virology, Department of Pathology University of Cape Town, Cape Town, South Africa.
3
Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
4
Department of Medicine, University of Cape Town, Cape Town, South Africa.
5
Department of Medicine, Imperial College London, United Kingdom.
6
The Francis Crick Institute, London, United Kingdom.

Abstract

The reconstitution of Mycobacterium tuberculosis (Mtb)-antigen-specific CD4 T cells in a cohort of HIV-infected persons starting antiretroviral treatment (ART) in high TB 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 Mtb sensitisation determined by IGRA, 12/23 participants had no Mtb-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

PMID:
31419285
DOI:
10.1093/infdis/jiz417
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