Eosinophilia and progression to active tuberculosis in HIV-1-infected Ugandans.
It has been suggested that type 1 immune responses protect against tuberculosis (TB), while type 2 responses, such as those induced by helminths, may suppress protective responses and increase susceptibility to TB. Factors associated with progression to active TB were investigated in a cohort of HIV-1-infected Ugandan adults, a group at high risk of TB. High rates of subsequent progression to active TB were associated with eosinophil counts > or = 0.4 x 10(9)/L at enrolment. Eosinophilia at enrolment was associated with male gender, low socio-economic status, high CD4+ T cell counts, and schistosomiasis, but adjusting for these factors did not explain the association of eosinophilia with progression to active TB (adjusted rate ratio = 2.76, P = 0.004). Eosinophilia is most likely to be indicative of a type 2 immune response induced by helminth infection in this Ugandan cohort, but the mechanism of the observed association between eosinophilia and risk of TB remains to be determined.
Elliott
Alison M
AM
Virus Research Institute, PO Box 49, Entebbe, Uganda. mrc@starcom.co.ug
Kyosiimire
Jacqueline
J
Quigley
Maria A
MA
Nakiyingi
Jessica
J
Watera
Christine
C
Brown
Michael
M
Joseph
Sarah
S
French
Neil
N
Gilks
Charles F
CF
Whitworth
James A G
JA
D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000328:Adult; D018450:Disease Progression; D004802:Eosinophilia / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D008297:Male; D012307:Risk Factors; D012552:Schistosomiasis / Q000150:complications; D012923:Social Class; D014376:Tuberculosis / Q000150:complications*