Background:The ability of antigen-specific T cells to simultaneously produce multiple cytokines has been associated with control of HIV and tuberculosis (TB). Dual infection with HIV and Mycobacterium tuberculosis (MTB) is thought to increase disease progression of both diseases. The aim of this study was to assess the impact of MTB infection on HIV-specific T cell functionality.Methods: We enrolled 13 HIV positive individuals with active TB, 9 HIV positive individuals with presumed latent MTB infection (LTBI), and 13 HIV positive individuals without evidence of LTBI or active TB. All subjects were chronically HIV infected adults from Durban, South Africa. All subjects were CD4+ matched. TB was identified by a positive sputum culture or positive sputum acid fast bacillus smear. LTBI was defined by a positive IFN-gamma ELISPOT using the RD-1 antigens ESAT-6 and CFP-10, in the absence of signs and symptoms of TB. We assessed T cell functionality by investigating IFNy, IL-2, TNF␣, IL-21 and IL-17 cytokine secretion capacity, using polychromatic flow cytomtery, following antigenspecific stimulation of PBMC.Results: HIV-specific CD4+ T cell polyfunctionality decreased progressively from those with HIV mono-infection, to those coinfected with LTBI, to those co-infected with TB. When compared to HIV mono-infected subjects, HIV positive individuals co-infected with LTBI displayed decreased HIV-specific CD4+ levels of IL-2 (p< 0.001) and IL-17 (p=0.001). When compared to HIV co-infected subjects with LTBI and those with HIV mono-infection, individuals co-infected with TB had decreased HIV-specific CD4+ levels of IFN-␥ (p<0.001) and TNF-␣ (p<0.001). A similar decrease in HIV-specific CD8+ T cell polyfunctionality was observed. When compared to HIV mono-infected subjects, HIV positive individuals co-infected with LTBI displayed decreased HIV-specific CD8+ levels of IFN␥ (p<0.001) and TNF-␣ (p<0.001). Conclusion:Our results indicate that MTB infection is linked to decreased HIV-specific T cell function. HIV-specific T cells were most defective in HIV co-infection with active TB compared to LTBI, suggesting that bacterial load may contribute to the loss of T cell function. This may be a contributing factor to the pathogenesis of co-infection as functionally defective HIV-specific T cells may be less able to control HIV.
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