Nalukwago Sophie, Lancioni Christina L, Oketcho Joy Baseke, Canaday Dave H E, Boom W Henry, Ojok Lonzy, Mayanja-Kizza Harriet
Joint Clinical Research Centre, Kampala, Uganda.
Department of Paediatric infectious diseases, Oregon Health Sciences University, Portland Oregon.
Afr Health Sci. 2017 Dec;17(4):954-962. doi: 10.4314/ahs.v17i4.2.
The reconstitution of cellular immune components contributes to clinical outcome of HIV and (MTB) infection. Interruption of anti-retroviral therapy (ART) could lead to perturbations in reconstitution of T cells in HIV/ tuberculosis (TB) patients.
To ascertain the effect of interrupted ART on reconstitution of CD4 and CD8 T sub-sets in TB patients.
Participants with HIV (CD4>350 cells/µL) and TB were recruited under a larger phase 3 open label randomised controlled clinical trial. The CD45RO and CD62L markers were measured on CD4 and CD8 cells by flow cytometry. Samples were analysed at baseline, 3, 6, 12 months.
There was a significant increase of naive CD8 cells (p = 0.003) and a decrease in effector CD8 cells (p = 0.004) among participants in ART/TB treatment arm during the first 6 months. Withdrawing ART led to naive CD8 cells reduction (p=0.02) to values close to baseline. An increase of naive CD8 cells after 6 months of TB treatment in TB alone treatment arm (p=0.01) was observed. A trend towards increment of naive CD4 sub sets in either treatment arms was observed.
Interrupting ART alters CD8 but not CD4 sub-sets in patients with less advanced HIV infection and TB.
细胞免疫成分的重建有助于艾滋病病毒（HIV）和结核分枝杆菌（MTB）感染的临床转归。抗逆转录病毒疗法（ART）的中断可能导致HIV/结核病（TB）患者T细胞重建受到干扰。
确定中断ART对TB患者CD4和CD8 T细胞亚群重建的影响。
在一项更大规模的3期开放标签随机对照临床试验中招募了HIV（CD4>350个细胞/微升）合并TB的参与者。通过流式细胞术检测CD4和CD8细胞上的CD45RO和CD62L标志物。在基线、3个月、6个月和12个月时对样本进行分析。
在ART/TB治疗组的参与者中，前6个月幼稚CD8细胞显著增加（p = 0.003），效应CD8细胞减少（p = 0.004）。停止ART导致幼稚CD8细胞减少（p = 0.02）至接近基线的值。在单纯TB治疗组中，观察到TB治疗6个月后幼稚CD8细胞增加（p = 0.01）。在两个治疗组中均观察到幼稚CD4亚群有增加的趋势。
在HIV感染和TB病情较轻的患者中，中断ART会改变CD8细胞亚群，但不会改变CD4细胞亚群。
