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Abstract
The occurrence of tuberculosis (TB) and hepatitis C virus (HCV) infections in the same patient presents a unique clinical challenge. The impact of HCV infection on the immune response to TB remains poorly investigated in TB+/HCV+ patients. This study was conducted to evaluate the impact of HCV on the T-cell-mediated immune response to TB in coinfected patients. Sixty-four patients with active TB infections were screened for coinfection with HCV. The expression of immune activation markers IFN-γ, CD38, and HLA-DR on TB-specific CD4+ T cells was evaluated by flow cytometry in TB-monoinfected patients, TB/HCV-coinfected patients, and healthy controls. IL-2, IL-4, IFN-γ, TNF-α, and IL-10 levels were measured using ELISA. The end-of-treatment response to anti-TB therapy was recorded for both patient groups. Significantly lower levels of CD4+IFN-γ+CD38+ and CD4+IFN-γ+HLA-DR+ T cells were detected in TB/HCV-coinfected patients compared to TB monoinfected patients and controls. TB+/HCV+-coinfected patients showed higher serum levels of IL-10. The baseline frequencies of TB-specific activated T-cell subsets did not predict the response to antituberculous therapy in TB+/HCV+ patients. We concluded that different subsets of TB-specific CD4+ T cells in TB/HCV-infected individuals are partially impaired in early-stage HCV infection. This was combined with increased serum IL-10 level. Such immune modulations may represent a powerful risk factor for disease progression in patients with HCV/TB coinfection.
Highlights
Infection with tuberculosis (TB) is one of the top 10 global causes of death
We aimed to explore the impact of hepatitis C virus (HCV) coinfection on the immune response to TB by analyzing the levels of immune activation markers IFN-γ, CD38, and HLA-DR
We reported a difference in the frequency of TB-specific IFN-γ+ CD38+ and IFN-γ+ HLA-DR+ CD4+ T cells in the TB/HCV group, we did not observe an association between the frequency of these cells and the outcome of infection or response to anti-TB therapy
Summary
Infection with tuberculosis (TB) is one of the top 10 global causes of death. World Health Organization (WHO) global report, TB globally infected about 9–11.1 million patients and accounted for about 1.2 million deaths among human immunodeficiency virus (HIV)-negative people in 2018. TB is endemic in Africa, which accounts for 24% of global TB cases. Viruses 2020, 12, 101 of active TB in Egyptians is 12 per 100,000 people. These numbers have been relatively stable over the last few years [1]. The hepatitis C virus (HCV) is a parentally transmitted hepatotropic virus that causes chronic infection in 55%–85% of cases. About 150 million individuals are infected with HCV [2]. Egypt is one of the countries most affected by HCV—demographic and health surveys measured antibody prevalence among the adult population to be 10% in 2015 [3]
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