title: The influence of influenza virus infections on the development of tuberculosis.
abstract: Recently, it was shown that interferon-γ mediated immune responses, which play a major role in the control of infection with Mycobacterium tuberculosis (Mtb), can be inhibited by type I interferons. Since type I interferons are abundantly induced during viral infections, we hypothesized that infections with influenza viruses might play a role in the development of active TB disease either directly after exposure to Mtb or through reactivation of latent Mtb infection. To explore this hypothesis we investigated in a retrospective study whether newly diagnosed adult tuberculosis patients from Indonesia had had recent influenza infection. Plasma samples from TB patients and controls were assayed for antibodies against two subtypes of at that time relevant, seasonal influenza A viruses. Overall, no correlation was observed with the presence of antibodies and manifest tuberculosis. Still, antibody titers against circulating A/H3N2 influenza virus were slightly enhanced in tuberculosis patients as compared to controls, and highest in cases of advanced tuberculosis. This suggests that tuberculosis patients were recently infected with influenza, before clinical manifestation of the disease. Alternatively, the production of antibodies and susceptibility to tuberculosis may be influenced by a common confounding factor, for example the ability of patients to induce interferon-α. We conclude that in an endemic country like Indonesia, an influenza virus infection is not a major determinant for developing clinically manifest tuberculosis.
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
authors.forename: Roelof A
authors.initials: RA
authors.lastname: de Paus
authors.forename: Reinout
authors.initials: R
authors.lastname: van Crevel
authors.forename: Ruud
authors.initials: R
authors.lastname: van Beek
authors.forename: Edhyana
authors.initials: E
authors.lastname: Sahiratmadja
authors.forename: Bachti
authors.initials: B
authors.lastname: Alisjahbana
authors.forename: Sangkot
authors.initials: S
authors.lastname: Marzuki
authors.forename: Guus F
authors.initials: GF
authors.lastname: Rimmelzwaan
authors.forename: Jaap T
authors.initials: JT
authors.lastname: van Dissel
authors.forename: Tom H M
authors.initials: TH
authors.lastname: Ottenhoff
authors.forename: Esther
authors.initials: E
authors.lastname: van de Vosse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D016022:Case-Control Studies; D060085:Coinfection / Q000453:epidemiology; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D009980:Influenza A virus / Q000276:immunology; D007251:Influenza, Human / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D014376:Tuberculosis / Q000150:complications* / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral