Abstract
Tuberculin skin testing (TST) response as a predictive tool for development of pulmonary tuberculosis (PT) in Human Immunodeficiency Virus type-1 (HIV-1) infected subjects, is likely to be more valuable at early stage of illness in order to adapt timely management strategy. Earlier reports on HIV-1 infected blood donors with history of oral iron intake and biochemical evidence of iron overload documented development of high incidence of PT on follow up.
Highlights
Co-infection of Human Immunodeficiency Virus (HIV) and Mycobacterium tuberculosis (M.tb) is a major public health problem in developing countries with high prevalence of tuberculosis (TB) [1]
Subclinical iron overload may mask TST response due to impaired production of IFN-γ by peripheral blood mononuclear cells (PBMC) to M. tuberculosis specific antigens that could be related to inadequate cooperation of interleukin 12 (IL-12) from macrophages
The present report attempts an evaluation of the predictive value of TST towards development of pulmonary tuberculosis (PT) on follow up in an asymptomatic group of antiretroviral therapy (ART) naïve Human Immunodeficiency Virus type-1 (HIV-1) infected blood donors in relation to baseline status of serum iron parameters, anergy testing response and production of IFN-γ by peripheral blood mononuclear cells (PBMCs) in response to mitogen phytohemagglutinin (PHA), live attenuated vaccine strain of Bacillus Calmette Guerrin (BCG) bacilli and M.tb specific antigen viz. protein purified derivative (PPD) in presence or absence of exogenous IL-12
Summary
Co-infection of Human Immunodeficiency Virus (HIV) and Mycobacterium tuberculosis (M.tb) is a major public health problem in developing countries with high prevalence of tuberculosis (TB) [1]. It has been advocated that assessment of cutaneous delayed type hypersensitivity (DTH) response to multiple recall antigens (anergy testing) could be a useful adjunct to TST for assessing general immune competency in HIV infected individuals [4]. Both these in vivo tests are based on production of the cytokine interferon gamma (IFN-γ) by peripheral CD4+ T lymphocytes with cooperative signal of interleukin 12 (IL-12) from macrophages [5]. Earlier reports on HIV-1 infected blood donors with history of oral iron intake and biochemical evidence of iron overload documented development of high incidence of PT on follow up
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