title: Tuberculosis distorts the inhibitory impact of interleukin-10 in HIV infection.
abstract: OBJECTIVE
  This study aimed to assess how Mycobacterium tuberculosis (MTB) coinfection alters the impact of interleukin-10 in chronic HIV infection.
  
  
  METHODS
  We assessed plasma cytokine levels (interleukin-10, interferon-γ, tumor necrosis factor-α, interleukin-2, interleukin-6 and interleukin-13) in 82 individuals presenting with HIV monoinfection, HIV-LTBI (latent MTB infection) coinfection or HIV-TB (active tuberculosis) coinfection. We also assessed the influence of MTB on the functional impact of interleukin-10 receptor alpha (interleukin-10Rα) blockade on HIV and MTB-specific CD4(+) T cells.
  
  
  METHODS
  Plasma cytokine levels were measured by high sensitivity Luminex. We used an ex-vivo interleukin-10Rα blockade assay to assess if functional enhancement of HIV and MTB-specific CD4(+) T cells was possible following a 48-h stimulation with HIV gag or pooled ESAT-6 (6 kDa early secretory antigenic target) and CFP-10 (10-kDa culture filtrate protein) peptides. Cell supernatant was collected 48 h after stimulation and the cytokine profile was measured by Luminex.
  
  
  RESULTS
  Plasma interleukin-10 levels were elevated in HIV-TB as compared with HIV monoinfection (P < 0.05) and HIV-LTBI (P < 0.05). Plasma interleukin-10 levels correlated to HIV viral load in HIV monoinfection (P = 0.016) and HIV-LTBI (P = 0.042), but not HIV-TB. Ex-vivo blockade of interleukin-10Rα significantly enhanced MTB and HIV-specific CD4(+) T-cell function in HIV-LTBI individuals but not in HIV-TB individuals.
  
  
  CONCLUSIONS
  Tuberculosis disrupts the correlation between interleukin-10 and markers of HIV disease progression. In addition, HIV-TB is associated with a more inflammatory cytokine milieu compared with HIV monoinfection. Interestingly, interleukin-10Rα blockade can enhance both HIV and MTB-specific T-cell function in HIV-LTBI, but not in HIV-TB coinfection.
authors.affiliation: aHIV Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal bKwaZulu-Natal Research Institute for TB and HIV (K-RITH), KwaZulu-Natal, Durban, South Africa cThe Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts dHoward Hughes Medical Institute, Chevy Chase, Maryland eDivision of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA fCentre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada gDivision of Medical Virology, University of Cape Town, Cape Town, South Africa. *Shivan Chetty and Filippos Porichis contributed equally to the writing of this article.
authors.forename: Shivan
authors.initials: S
authors.lastname: Chetty
authors.forename: Filippos
authors.initials: F
authors.lastname: Porichis
authors.forename: Pamla
authors.initials: P
authors.lastname: Govender
authors.forename: Jennifer
authors.initials: J
authors.lastname: Zupkosky
authors.forename: Musie
authors.initials: M
authors.lastname: Ghebremichael
authors.forename: Mona
authors.initials: M
authors.lastname: Pillay
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Walker
authors.forename: Thumbi
authors.initials: T
authors.lastname: Ndung'u
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Kaufmann
authors.forename: Victoria O
authors.initials: VO
authors.lastname: Kasprowicz
mesh_terms: D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D015658:HIV Infections / Q000150:complications* / Q000276:immunology*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood* / Q000276:immunology; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D014376:Tuberculosis / Q000150:complications* / Q000276:immunology*
chemical_list: D016753:Interleukin-10