Impact of HIV Infection on Latent TB Among Patients With HIV-TB Co-infection
Impact of HIV Infection on Latent TB Among Patients With HIV-TB Co-infection
HIV induced altered representation and function of regulatory T cell subsets (NKT and Treg cells) impair the protective T cell response against M.tuberculosis and disrupts LTBI, thus facilitates faster progression and development of severe forms of clinical TB in HIV-TB co-infection.
During the natural course of HIV disease, emergence of opportunistic infection not only imposes morbidity on HIV-TB co-infected patients, but also facilitates viral replication causing faster disease progression. Tuberculosis, being the commonest among the opportunistic infections among HIV infected persons deserves special attention. Moreover, disruption of latency of TB infection (LTBI) with development of more severe clinical forms at relatively early stage of HIV disease when CD4 count still remains above 300/ul, makes TB a unique opportunistic infection and negatively influence the outcome of dual infection.This is suggestive of impairment of some critical immune function involving relatively less frequent fine T cell subsets with functional hierarchy over bulk T cells, so as to weaken the immune containment of LTBI resulting in reactivation of M. tuberculosis and manifestation of severe forms of TB.HIV has recently been reported to preferentially infect, destroy and incapacitate two key immune-regulatory T cell subsets, namely NKT and Treg cells.Therefore, studying them along the course of HIV disease and impact of their changes on the function of effector T cells directed against M.tuberculosis is important.
Inclusion Criteria:
HIV infected +LTBI group:
HIV infected + Clinical TB group:
Patient of either sex between 18-65 years of age
All the patients should be HIV ELISA test positive irrespective of CD4 count and presence of other opportunistic infections
In PTB group, patient should be two sputum smear positive out of three consecutive samples
In EPTB group, diagnosis of TB will be:
Written informed consent to participate in the study given by participants or legal guardian
Patients able to comply with instructions and come back for a regular follow up
HIV negative Clinical TB group:
Patients of either sex between 18-65 years of age who are permanent resident of Delhi
All patients should be HIV ELISA negative
In PTB group, patients should be two sputum smear positive (at least 1+) out of three consecutive samples
In EPTB group, diagnosis of TB will be:
Written informed consent to participate in the study given by participants or legal guardian
Patients able to comply with instructions and come back for a regular follow up
Normal controls:
Persons of either sex between 18-65 years of age who are permanent resident of Delhi
Written informed consent to participate in the study given by participants or legal guardian
Person should not have past history of TB
Renal and liver functions normal
Hepatitis viral markers normal
No clinical evidence of malnutrition
HIV ELISA negative
Exclusion Criteria:
HIV infected +LTBI group:
HIV infected + Clinical TB group:
HIV negative Clinical TB group:
Normal controls:
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surensk@gmail.com26594415
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