CHARACTERISTICS OF SOME IMMUNOLOGICAL INDICATORS OF HIV INFECTION IN COMBINATION WITH TUBERCULOSIS

Abstract

The purpose of the work is to carry out a comparative analysis of epidemiological, clinical and individual laboratory parameters of groups of patients with HIV infection associated with tuberculosis (TB) and TB monoinfection.

Patients and methods. A comprehensive immunological examination was performed on 231 patients, including 155 HIV-infected with active newly diagnosed tuberculosis and 76 on tuberculosis alone. The HIV/TB group was divided into 3 subgroups depending on the time of TB accession to HIV infection.

The levels of interleukin-4 (IL-4) and interferon-γ (IFN-γ) were compared for groups with co-infection with HIV/TB and patients with TB monoinfection.

Results. In associated HIV/TB infection, the level of CD4⁺T-lymphocytes is significantly lower compared to patients with TB monoinfection.

In the HIV/TB group, it was established the presence of a medium feedback force between the number of CD4⁺T-lymphocytes and the serum concentration of IFN-γ (correlation coefficient r=-0.36, confidence level P<0.05); weak direct relationship between viral load and serum IFN-γ concentration (r=0.25, P<0.05); medium strength inverse relationship between the number of CD4⁺T-lymphocytes and the level of viral load (r=-0.44, P<0,01). In the group with TB monoinfection, no correlation was found between the number of CD4⁺T-lymphocytes and cytokine parameters.

Conclusions. In associated HIV/TB infection, CD4⁺T-lymphocyte counts are significantly lower than in patients with TB only.

As HIV infection progresses (decrease in CD4⁺T-lymphocytes and increase in HIV load), there is an increase in serum IFN-γ and IL-4, which probably indicates a decrease in the number of anti-inflammatory T-regulatory cells, or a decrease in their suppressor activity.