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Tuberculosis (TB) kills 2 million people per year and infection with HIV is the most potent known risk factor for progression to active TB. An understanding of the immune response to TB Ags in HIV-infected patients is required to develop optimal TB vaccines and diagnostics. We assessed polyfunctional (IFN-gamma(+)IL-2(+)TNF-alpha(+)) T cell responses to TB Ags in three groups of HIV-1-infected patients dependent on their TB status, CD4 counts, and anti-retroviral exposure. We found that although the proportion of IFN-gamma cells in response to TB Ags was higher in patients with low CD4 counts, the responding cells changed from a polyfunctional CD4(+) to a monofunctional CD8(+) response. The overall polyfunctionality of the cells was restored by 12 mo of anti-retroviral therapy and primarily involved CD4(+) T cells with an effector memory phenotype. These findings have major implications for diagnosis of TB and in vaccine development strategies for TB in HIV-1-infected patients.

Original publication

DOI

10.4049/jimmunol.1000399

Type

Journal article

Journal

J Immunol

Publication Date

01/06/2010

Volume

184

Pages

6537 - 6544

Keywords

Adult, Anti-Retroviral Agents, Antigens, Bacterial, CD4-Positive T-Lymphocytes, CD8-Positive T-Lymphocytes, Cell Separation, Female, Flow Cytometry, HIV Infections, HIV-1, Humans, Male, Middle Aged, Tuberculosis, Young Adult