title: Cytolytic T-cell activity against mycobacterial antigens in HIV.
abstract: OBJECTIVE
  The declining incidence of tuberculosis (TB) in developed countries has recently been reversed with the advent of HIV disease. This study proposes to document in vitro T-cell responses to mycobacterial antigens in HIV-infected individuals.
  
  
  METHODS
  T-cell-mediated immunity is recognized as one of the mechanisms of defence against TB. The cellular immunodeficiency and the importance of TB in the context of HIV disease has prompted use of in vitro assays of lymphocyte proliferation and cytolytic activity.
  
  
  METHODS
  Peripheral blood mononuclear cells isolated from 29 HIV-infected patients (four with recent TB) and 11 healthy volunteers were stimulated with purified protein derivative (PPD). The responding blasts were presented to autologous antigen-primed macrophages to measure specific cytolytic T-lymphocyte (CTL) activity in vitro.
  
  
  RESULTS
  T-cell proliferative responses were significantly lower in late stages of HIV disease. The degree of specific CTL activity was higher in healthy individuals than in Centers for Disease Control (CDC) stage II-III (P = 0.037), and CDC stage IV patients (P = 0.029).
  
  
  CONCLUSIONS
  The clinical presentation of TB tends to be typical in early stages of HIV disease and atypical in late stages. The manifestations reflect the degree of immunodepression. This study documents the declining proliferative and cytolytic T-cell-mediated responses in HIV patients with progression of immunodeficiency.
authors.affiliation: Department of Communicable and Tropical Diseases, East Birmingham Hospital, UK.
authors.forename: M
authors.initials: M
authors.lastname: Forte
authors.forename: G
authors.initials: G
authors.lastname: Maartens
authors.forename: M
authors.initials: M
authors.lastname: Rahelu
authors.forename: J
authors.initials: J
authors.lastname: Pasi
authors.forename: C
authors.initials: C
authors.lastname: Ellis
authors.forename: H
authors.initials: H
authors.lastname: Gaston
authors.forename: D
authors.initials: D
authors.lastname: Kumararatne
mesh_terms: D000293:Adolescent; D000328:Adult; D000942:Antigens, Bacterial / Q000276:immunology*; D003602:Cytotoxicity, Immunologic; D000939:Epitopes / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*; D014373:Tuberculin / Q000276:immunology
chemical_list: D000942:Antigens, Bacterial; D000939:Epitopes; D014373:Tuberculin