[Immune mechanisms of comorbidity of HIV infection and pulmonary tuberculosis].

AIM

to study the immune system in patients with tuberculosis-associated HIV infection at different stages of disease and during antiretroviral therapy (ARVT).

SUBJECTS AND METHODS

The study included 90 patients with tuberculosis-associated HIV infection; a control group comprised 117 HIV-infected patients. The total number of T lymphocytes and their subpopulations (CD3+, CD4+, and CD8+) and the levels of the cytokines TNF-alpha, IL-6, and their soluble receptors SRp55 of TNF-alpha (type I), SRp75 of TNF-alpha (type II), and SR of IL-6 in the serum.

RESULTS

T-cell immunodeficiency was detected at all stages of HIV infection accompanied by CD3+ and CD4+ cell deficiency and decreased immunoregulatory index. The cytokine profile changes were indicative of a more noticeable reduction in the functional activity of T helper cells type I in patients with HIV-associated tuberculosis.

CONCLUSION

The efficiency of ARVT in patients with HIV-associated tuberculosis was confirmed by a lower viral load and higher CD4+ cells. Heterodirectional changes in the content of cytokines and their receptors characterized by a considerable increase in the levels of TNF-alpha, IL-6, SR of TNF-alpha and a drastic reduction in the level of SR of IL-6 may be considered as a marker of immune recovery.