Tuberculosis (TB) is the most common opportunistic infection in human immunodeficiency virus type 1 (HIV-1)-infected patients globally and occurs throughout the course of HIV-1 disease. Here the production of interferon (IFN)-γ and tumor necrosis factor (TNF)-α by peripheral blood mononuclear cells (PBMC) of HIV-1-infected versus -uninfected patients with newly diagnosed pulmonary TB (PTB) was compared. Findings were correlated with cytokine profiles, clinical presentation, and expression of inducible nitric oxide (iNOS). Most HIV-1/PTB patients with a CD4 cell count of 200-500 cells/μL had high IFN-γ production and radiographic evidence of atypical PTB. Low IFN-α production and radiographic evidence of reactivated PTB characterized both HIV-1/PTB patients with a CD4 cell count ≥500 cells/μL and HIV-1-uninfected patients. TNF-α levels were similar in all HIV-1/PTB patients, regardless of CD4 cell count. Induction of iNOS in PBMC was low and was associated with low IFN-α production. These data underscore the potential pathogenic role of macrophage-activating cytokines in TB in HIV-1-infected patients.
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health