title: HIV-1 and the immune response to TB.
abstract: TB causes 1.4 million deaths annually. HIV-1 infection is the strongest risk factor for TB. The characteristic immunological effect of HIV is on CD4 cell count. However, the risk of TB is elevated in HIV-1 infected individuals even in the first few years after HIV acquisition and also after CD4 cell counts are restored with antiretroviral therapy. In this review, we examine features of the immune response to TB and how this is affected by HIV-1 infection andvice versa. We discuss how the immunology of HIV-TB coinfection impacts on the clinical presentation and diagnosis of TB, and how antiretroviral therapy affects the immune response to TB, including the development of TB immune reconstitution inflammatory syndrome. We highlight important areas of uncertainty and future research needs.
authors: Infectious Diseases & Immunity, Imperial College London, W12 0NN, UK ; Clinical Infectious Diseases Research Initiative, Institute of Infectious Diseases & Molecular Medicine, University of Cape Town, Observatory 7925, South Africa.
authors: Naomi F
authors: NF
authors: Walker
authors: Graeme
authors: G
authors: Meintjes
authors: Robert J
authors: RJ
authors: Wilkinson
keywords: ART; HIV; TB; TB-IRIS; TB-associated immune reconstitution inflammatory syndrome; antiretroviral therapy; diagnosis; immunity; immunopathology; tuberculosis
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