title: Macrophage-activating cytokines in human immununodeficiency virus type 1-infected and -uninfected patients with pulmonary tuberculosis.
abstract: 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)-gamma and tumor necrosis factor (TNF)-alpha 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/microL had high IFN-gamma production and radiographic evidence of atypical PTB. Low IFN-gamma production and radiographic evidence of reactivated PTB characterized both HIV-1/PTB patients with a CD4 cell count >or=500 cells/microL and HIV-1-uninfected patients. TNF-alpha 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-gamma production. These data underscore the potential pathogenic role of macrophage-activating cytokines in TB in HIV-1-infected patients.
authors.affiliation: Department of Internal Medicine, Makerere University Medical School, Kampala, Uganda.
authors.forename: H
authors.initials: H
authors.lastname: Mayanja-Kizza
authors.forename: J L
authors.initials: JL
authors.lastname: Johnson
authors.forename: C S
authors.initials: CS
authors.lastname: Hirsch
authors.forename: P
authors.initials: P
authors.lastname: Peters
authors.forename: K
authors.initials: K
authors.lastname: Surewicz
authors.forename: M
authors.initials: M
authors.lastname: Wu
authors.forename: G
authors.initials: G
authors.lastname: Nalugwa
authors.forename: F
authors.initials: F
authors.lastname: Mubiru
authors.forename: H
authors.initials: H
authors.lastname: Luzze
authors.forename: A
authors.initials: A
authors.lastname: Wajja
authors.forename: H
authors.initials: H
authors.lastname: Aung
authors.forename: J J
authors.initials: JJ
authors.lastname: Ellner
authors.forename: C
authors.initials: C
authors.lastname: Whalen
authors.forename: Z
authors.initials: Z
authors.lastname: Toossi
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology*; D000328:Adult; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D015497:HIV-1; D006801:Humans; D007371:Interferon-gamma / Q000096:biosynthesis*; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D008262:Macrophage Activation; D008875:Middle Aged; D009569:Nitric Oxide / Q000096:biosynthesis; D013902:Radiography, Thoracic; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis*
chemical_list: D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide; D007371:Interferon-gamma