Impact of HIV co-infection on plasma level of cytokines and chemokines of pulmonary tuberculosis patients

Yonas Bekele,Gerhard Walzl,Markos Abebe,Rawleigh Howe,Adane Mihret,Abraham Aseffa

doi:10.1186/1471-2334-14-125

Abstract

BackgroundThe immunologic environment during HIV/M. tuberculosis co-infection is characterized by cytokine and chemokine irregularities that have been shown to increase immune activation, viral replication, and T cell dysfunction.MethodsWe analysed ex vivo plasma samples from 17 HIV negative and 16 HIV pulmonary tuberculosis co infected cases using Luminex assay to see impact of HIV co-infection on plasma level of cytokines and chemokines of pulmonary tuberculosis patients before and after anti Tuberculosis treatment.ResultsThe median plasma level of IFN-γ, IL-4, MCP-3, MIP-1β and IP-10 was significantly different (P < 0.05) before and after treatment in HIV negative TB patients but not in HIV positive TB patients. There was no significant difference between HIV positive and HIV negative TB patients (P > 0.05) in the plasma level of any of the cytokines or chemokines before treatment and anti TB treatment did not change the level of any of the measured cytokines in HIV positive tuberculosis patients. The ratio of IFN-γ/IL-10 and IFN-γ/IL-4 showed a significant increase after treatment in HIV negative TB cases but not in HIV positive TB cases which might indicate prolonged impairment of immune response to TB in HIV positive TB patients as compared to HIV negative tuberculosis patients.ConclusionsHIV positive and HIV negative Tuberculosis patients display similar plasma cytokine and chemokine pattern. However, anti TB treatment significantly improves the Th1 cytokines and level of chemokines but does not restore the immune response in HIV positive individuals.

Highlights

The immunologic environment during HIV/M. tuberculosis co-infection is characterized by cytokine and chemokine irregularities that have been shown to increase immune activation, viral replication, and T cell dysfunction
Effect of HIV on plasma level of cytokines and chemokines on TB patients We found that the median plasma level of the cytokines and chemokines measured was not affected by HIV status the HIV positive TB patients have a slightly higher level of most of the cytokines and chemokines (Figure 1)
We found that the median level of IFN-γ, IL-4, IP-10, MCP-3 and MIP-1β were statistically different (p < 0.05) after treatment in HIV negative TB patients but not in HIV positive TB patients (p > 0.05) (Figure 2)

Summary

Introduction

The immunologic environment during HIV/M. tuberculosis co-infection is characterized by cytokine and chemokine irregularities that have been shown to increase immune activation, viral replication, and T cell dysfunction. A high risk of TB has been shown in early stages of the HIV disease, even in the presence of normal CD4+ cell counts [2]. The factors contributing to this increased risk are not clear, but may include a compromised response by CD4+ T cells, defective. In order to understand the immune profile of TB disease and infection, a number of parameters need to be considered. These include the HIV status with the majority of diagnostic tests not applicable for HIV positive patients. The cytokine response to TB antigens has been studied extensively but results have varied possibly due to differences in the genetic background of the study population, the type and length of antigen stimulation, the experimental protocol used and the sample type [5,6,7]

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