title: Lack of Response to HBHA in HIV-Infected Patients with Latent Tuberculosis Infection.
abstract: Heparin-binding haemagglutinin (HBHA) has been proposed as an immunological biomarker for discriminating active tuberculosis (TB) from latent TB infection (LTBI) and to identify those at higher risk of progressing to active disease. Few data are available in immune-compromised patients, which are those with increased risk of TB reactivation. The aim of this stusy was to evaluate the immune response to HBHA in HIV-infected subjects with LTBI (HIV-LTBI) or active TB (HIV-TB) in comparison with the immune response to additional Mycobacterium tuberculosis (Mtb) or HIV and CMV antigens. The responses are evaluated in relation to TB status and in the LTBI subjects with the progression to active TB within 2 years. Forty-one HIV-infected antiretroviral-naïve subjects were prospectively enrolled: 18 were HIV-TB and 23 HIV-LTBI. Whole blood was in vitro stimulated overnight with several antigens and mitogen. Interferon-γ response in the harvested plasma was evaluated by ELISA. Despite that CD4 cell count was significantly different between HIV-LTBI and HIV-TB, no differences were observed in response to Mtb- or HIV-specific antigens. Differently, low responses to HBHA were observed in both HIV-LTBI and HIV-TB subjects. Importantly, none of the six HIV-LTBI responding to HBHA developed TB, while two of 17 non-HBHA responders developed active disease. HIV-TB-coinfected subjects, regardless of their TB status, showed low responses to HBHA despite maintaining detectable responses to other antigens; moreover, among the HIV-LTBI, the lack of HBHA responses indicated an increased risk to develop active TB. These results, although preliminary, suggest that a positive response to HBHA in HIV-LTBI correlates with Mtb containment.
authors.affiliation: Epidemiology Department, National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Rome, Italy.|Institute of Microbiology, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Delogu
authors.affiliation: Translational Research Unit, Epidemiology Department, National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Vanini
authors.affiliation: Translational Research Unit, Epidemiology Department, National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cuzzi
authors.affiliation: Translational Research Unit, Epidemiology Department, National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Rome, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Chiacchio
authors.affiliation: Institute of Microbiology, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: De Maio
authors.affiliation: Institute of Microbiology, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Battah
authors.affiliation: Clinical Department, National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pinnetti
authors.affiliation: Clinical Department, National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Sampaolesi
authors.affiliation: Clinical Department, National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Antinori
authors.affiliation: Translational Research Unit, Epidemiology Department, National Institute for Infectious Diseases, IRCCS "Lazzaro Spallanzani", Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Goletti
mesh_terms: D000328:Adult; D001426:Bacterial Proteins / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D002478:Cells, Cultured; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D015488:HIV Antigens / Q000276:immunology; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D007371:Interferon-gamma / Q000097:blood; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis*; D008213:Lymphocyte Activation; D008297:Male; D008565:Membrane Proteins / Q000276:immunology*; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*
chemical_list: D001426:Bacterial Proteins; D015415:Biomarkers; D015488:HIV Antigens; C440647:HbhA protein, Mycobacterium tuberculosis; D008565:Membrane Proteins; D007371:Interferon-gamma