Toossi Z, Mayanja-Kizza H, Hirsch C S, Edmonds K L, Spahlinger T, Hom D L, Aung H, Mugyenyi P, Ellner J J, Whalen C W
Department of Medicine, Case Western Reserve University and Veterans Administration Medical Center, Cleveland, OH 44106-4984, USA.
Clin Exp Immunol. 2001 Feb;123(2):233-8. doi: 10.1046/j.1365-2249.2001.01401.x.
Active TB in HIV-1-infected subjects is associated with increased HIV-1-related immunodeficiency and mortality. We assessed plasma viral load in HIV-1-infected patients with pulmonary TB (HIV/TB) and non-TB symptomatic HIV-1-infected patients (HIV). HIV-1 load was higher in HIV/TB compared with HIV at higher CD4 counts (> 500/microl) (P < 0.01), but not at lower CD4 counts (< 500/microl). We also evaluated the status of HIV-1 gene expression in peripheral blood mononuclear cells (PBMC) and serum from HIV/TB and CD4-matched healthy HIV-infected patients (HIV/C) by reverse transcriptase-polymerase chain reaction over a range of CD4 (> 900/microl to < 200/microl). HIV-1 RNA in serum and PBMC correlated to one another, and both were markedly higher in HIV/TB compared with HIV/C with higher CD4 counts. Also, during a longitudinal study of anti-tuberculous chemoprophylaxis in HIV-1-infected patients, 10 subjects who developed TB had serologies before, at the time, and after the diagnosis of TB. These HIV/TB patients had an increase in viral load (average 2.5-fold) at the time of diagnosis of TB (P < 0.05). Overall, these data indicate that the transcriptional activity of HIV-1 is enhanced in HIV-1-infected patients with active TB, especially during early HIV-1 disease. As TB often is an early HIV-1 opportunistic infection, it may particularly favour early viral replication and dissemination, and therefore contribute to progression of HIV-1 disease.
HIV-1感染患者的活动性结核病与HIV-1相关免疫缺陷及死亡率增加有关。我们评估了合并肺结核的HIV-1感染患者（HIV/TB）及有症状但未患结核病的HIV-1感染患者（HIV）的血浆病毒载量。在CD4细胞计数较高（>500/微升）时，HIV/TB患者的HIV-1载量高于HIV患者（P<0.01），但在CD4细胞计数较低（<500/微升）时并非如此。我们还通过逆转录聚合酶链反应评估了HIV/TB患者及CD4细胞计数匹配的健康HIV感染患者（HIV/C）外周血单个核细胞（PBMC）和血清中HIV-1基因表达状态，CD4细胞计数范围为>900/微升至<200/微升。血清和PBMC中的HIV-1 RNA相互关联，在CD4细胞计数较高时，HIV/TB患者的二者水平均显著高于HIV/C患者。此外，在一项针对HIV-1感染患者的抗结核化学预防纵向研究中，10名发生结核病的受试者在结核病诊断前、诊断时及诊断后均进行了血清学检测。这些HIV/TB患者在结核病诊断时病毒载量增加（平均2.5倍）（P<0.05）。总体而言，这些数据表明，活动性结核病的HIV-1感染患者中HIV-1的转录活性增强，尤其是在HIV-1疾病早期。由于结核病通常是早期HIV-1机会性感染，它可能特别有利于病毒早期复制和传播，从而促进HIV-1疾病进展。
