title: Impact of tuberculosis (TB) on HIV-1 activity in dually infected patients.
abstract: Active TB in HIV-1-infected subjects is associated with increased HIV-1-related immunodeficiency and mortality. We assessed plasma viral load in HIV-1-infected patients with pulmonary TB (HIV/TB) and non-TB symptomatic HIV-1-infected patients (HIV). HIV-1 load was higher in HIV/TB compared with HIV at higher CD4 counts (> 500/microl) (P < 0.01), but not at lower CD4 counts (< 500/microl). We also evaluated the status of HIV-1 gene expression in peripheral blood mononuclear cells (PBMC) and serum from HIV/TB and CD4-matched healthy HIV-infected patients (HIV/C) by reverse transcriptase-polymerase chain reaction over a range of CD4 (> 900/microl to < 200/microl). HIV-1 RNA in serum and PBMC correlated to one another, and both were markedly higher in HIV/TB compared with HIV/C with higher CD4 counts. Also, during a longitudinal study of anti-tuberculous chemoprophylaxis in HIV-1-infected patients, 10 subjects who developed TB had serologies before, at the time, and after the diagnosis of TB. These HIV/TB patients had an increase in viral load (average 2.5-fold) at the time of diagnosis of TB (P < 0.05). Overall, these data indicate that the transcriptional activity of HIV-1 is enhanced in HIV-1-infected patients with active TB, especially during early HIV-1 disease. As TB often is an early HIV-1 opportunistic infection, it may particularly favour early viral replication and dissemination, and therefore contribute to progression of HIV-1 disease.
authors.affiliation: Department of Medicine, Case Western Reserve University and Veterans Administration Medical Center, Cleveland, OH 44106-4984, USA. zxt2@po.cwru.edu
authors.forename: Z
authors.initials: Z
authors.lastname: Toossi
authors.forename: H
authors.initials: H
authors.lastname: Mayanja-Kizza
authors.forename: C S
authors.initials: CS
authors.lastname: Hirsch
authors.forename: K L
authors.initials: KL
authors.lastname: Edmonds
authors.forename: T
authors.initials: T
authors.lastname: Spahlinger
authors.forename: D L
authors.initials: DL
authors.lastname: Hom
authors.forename: H
authors.initials: H
authors.lastname: Aung
authors.forename: P
authors.initials: P
authors.lastname: Mugyenyi
authors.forename: J J
authors.initials: JJ
authors.lastname: Ellner
authors.forename: C W
authors.initials: CW
authors.lastname: Whalen
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology / Q000821:virology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D015658:HIV Infections / Q000150:complications / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000382:microbiology / Q000821:virology*; D019562:Viral Load