Mycobacterium tuberculosis induces expression of P-glycoprotein in promonocytic U1 cells chronically infected with HIV type 1.

A productive infection with HIV-1 is associated with an increased expression of a 170 kd plasma membrane P-glycoprotein (P-gp), that functions as a metabolically active drug efflux pump, in human T and macrophage cell lines. In this investigation we show that phagocytosis of M. tuberculosis by U1 cells, that are chronically infected with HIV-1 but produce minimal or no virus, resulted in an expression of P-gp that was associated with increased production of HIV-1 p24 antigen. In addition, U1 cells that had phagocytosed M. tuberculosis accumulated significantly less intracellular isoniazid (INH) as compared to U1 cells. Furthermore, verapamil, that binds to P-gp, increased the intracellular accumulation of INH and the sensitivity of M. tuberculosis to INH. These data suggest induction of P-gp expression may be one of the host mechanisms for the development of multidrug resistant M. tuberculosis in HIV 1 infection.