Wellcome Center for Infectious Disease Research in Africa, University of Cape Town, South Africa.
Division of Medical Virology, Department of Pathology, University of Cape Town, South Africa.
J Infect Dis. 2020 Jan 1;221(1):162-167. doi: 10.1093/infdis/jiz417.
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.
本研究描述了在高结核流行地区开始抗逆转录病毒治疗（ART）的 HIV 感染者队列中，结核分枝杆菌抗原特异性 CD4 T 细胞的重建情况。抗原特异性 CD4 T 细胞亚群的恢复与总 CD4 T 细胞区室相吻合。尽管通过干扰素-γ释放试验（IGRA）确定了已知的结核分枝杆菌致敏，但在 ART 期间，活化（通过 HLA-DR 表达评估）下降，但与 HIV 未感染者相比仍处于较高水平。23 名参与者中有 12 名通过流式细胞术无法检测到结核分枝杆菌特异性 CD4 T 细胞，同时总 T 细胞活化和记忆分化升高，这表明细胞更新加快。我们的数据表明早期 ART 启动以维持多功能免疫记忆反应。
