RESUMO
Characterizing perturbations in the immune response to tuberculosis in HIV can develop insights into the pathogenesis of coinfection. HIV+ TB+ and TB monoinfected (TB+) subjects recruited from clinics in Bamako prior to initiation of TB treatment were evaluated at time-points following initiation of therapy. Flow cytometry assessed CD4+/CD8+ T cell subsets and activation markers CD38/HLA-DR. Antigen specific responses to TB proteins were assessed by intracellular cytokine detection and proliferation. HIV+ TB+ subjects had significantly higher markers of immune activation in the CD4+ and CD8+ T cells compared to TB+ subjects. HIV+ TB+ had lower numbers of TB-specific CD4+ T cells at baseline. Plasma IFNγ levels were similar between HIV+ TB+ and TB+ subjects. No differences were observed in in-vitro proliferative capacity to TB antigens between HIV+ TB+ and TB+ subjects. Subjects with HIV+ TB+ coinfection demonstrate in vivo expansion of TB-specific CD4+ T cells. Immunodeficiency associated with CD4+ T cell depletion may be less significant compared to immunosuppression associated with HIV viremia or untreated TB infection.
Assuntos
Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Coinfecção/imunologia , Infecções por HIV/imunologia , Tuberculose Pulmonar/imunologia , ADP-Ribosil Ciclase 1/imunologia , Adulto , Fármacos Anti-HIV/uso terapêutico , Antígenos de Bactérias/imunologia , Antituberculosos/uso terapêutico , Proliferação de Células , Coinfecção/tratamento farmacológico , Feminino , Citometria de Fluxo , Infecções por HIV/tratamento farmacológico , Antígenos HLA-DR/imunologia , Humanos , Interferon gama/imunologia , Interleucina-10/imunologia , Interleucina-12/imunologia , Interleucina-13/imunologia , Interleucina-2/imunologia , Ativação Linfocitária/imunologia , Masculino , Tuberculose Pulmonar/tratamento farmacológico , Fator de Necrose Tumoral alfa/imunologiaRESUMO
Cette etude decrit les infirmites lepreuses observees chez les 275 nouveaux patients de l'essai multicentrique; OMS/THMYEC des regions combines associant l'oflaxacine rifampicine dans le traitement de la lepre; au moment de l'inclusion. Cet essai a debute en octobre 1992 et a ete realise dans la region de Koulikoro au Mali. Sur les 275 inclus 76 (26;7 pour cent) etaient porteurs d'infirmites au depistage dont 40 (14;5 pour cent) de degre 2. La repartition de ses infirmites a montre une predominance masculine 47 cas (33;8 pour cent p=0.02); une predominance dans la forme MB 36 cas (43;9 pour cent p=0.01) et une augmentation en fonction de l'age de 21 cas (20;6 pour cent) chez les sujets jeunes a 30 cas (41;7 pour cent) chez les sujets ages (p=0.01)
Assuntos
Hanseníase/complicaçõesRESUMO
Le clone III-1 de Neisseria meningitidis sérogroupe A était inconnu en Afrique jusqu'en 1988. Depuis cette date; nous assistons à une vague épidémique secouant la plupart des pays de l'Afrique centrale et de l'Afrique de l'Est. Nous avons montré une étude des protéines de membrane externe; que la souche de méningocoque responsable de l'épidémie du Mali depuis 1994 est le clone III-I
