Tuberculosis Antigen-Specific T-Cell Responses During the First 6 Months of Antiretroviral Treatment.

Riou, Catherine; Jhilmeet, Nishtha; Rangaka, Molebogeng X; Wilkinson, Robert J; Wilkinson, Katalin A · J Infect Dis · 2020

prospective_cohort · Level II

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Abstract

The reconstitution of Mycobacterium tuberculosis antigen-specific CD4 T cells in a cohort of HIV-infected persons starting antiretroviral treatment (ART) in a high tuberculosis endemic area is described. Restoration of the antigen-specific CD4 T-cell subsets mirrored the overall CD4 T-cell compartment. Activation (assessed by HLA-DR expression) decreased during ART but remained elevated compared to HIV-uninfected persons. Despite known M. tuberculosis sensitization determined by interferon-γ release assay, 12/23 participants had no M. tuberculosis-specific CD4 T cells detectable by flow cytometry, combined with overall elevated T-cell activation and memory differentiation, suggesting heightened turnover. Our data suggest early ART initiation to maintain polyfunctional immune memory responses.

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