Changes in HIV RNA viral load, CD4+ T-cell counts, and levels of immune activation markers associated with anti-tuberculosis therapy and cotrimoxazole prophylaxis among HIV-infected tuberculosis patients in Abidjan, Cote d'Ivoire.
We analyzed changes in plasma human immunodeficiency virus (HIV)-1 viral load, CD4+ T-cell count, and markers of immune activation markers at start of treatment of tuberculosis and 12 months after among 44 HIV-1-infected patients with newly diagnosed, sputum-smear positive for Mycobacterium tuberculosis pulmonary infection. All patients received a standard regimen of 6 months of rifampicin and isoniazid with first 2 months of pyrazinamid with or without cotrimoxazole. Compared with values at start of treatment, median viral load increased by a median of 0.64 log10 copies/ml after 12 months of follow-up (P=0.0002). Median CD4+ T-cell counts were 393 cells/L at start of treatment and 370 cells/L after 12 months of follow-up (P=0.61). Levels of serum activation markers decreased significantly at 12 months of follow-up of the patients for both patients on standard and cotrimoxazole treatment. Levels of viral load, CD4+ T-cell counts, and markers of immune activation were not different for patients on standard treatment of tuberculosis compared with those on standard and cotrimoxazole treatment. Levels of serum activation markers decreased significantly at 12 months of follow-up of the patients for both patients on standard and cotrimoxazole treatment. Because viral load is a predictor of disease progression, its persistent elevated levels in blood of HIV-infected patients co-infected with tuberculosis, who successfully complete TB treatment, may account for the high mortality observed in this population.
Kalou
Mireille
M
Projet RETRO-CI, Abidjan, Côte d'Ivoire.
Sassan-Morokro
Madeleine
M
Abouya
Lucien
L
Bile
Célestin
C
Maurice
Chantal
C
Maran
Mathieu
M
Tossou
Odette
O
Roels
Thierry
T
Greenberg
Alan E
AE
Wiktor
Stefan Z
SZ
Nkengasong
John N
JN
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000821:virology; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects*; D007560:Cote d'Ivoire; D016207:Cytokines / Q000097:blood; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000097:blood; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*; D014376:Tuberculosis / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D019562:Viral Load
D000995:Antitubercular Agents; D015415:Biomarkers; D016207:Cytokines; D012367:RNA, Viral; D015662:Trimethoprim, Sulfamethoxazole Drug Combination