Macrophage‐Activating Cytokines in Human Immununodeficiency Virus Type 1–Infected and –Uninfected Patients with Pulmonary Tuberculosis

Abstract
Tuberculosis (TB) is the most common opportunistic infection in human immunodeficiency virus type 1 (HIV-1)–infected patients globally and occurs throughout the course of HIV-1 disease. Here the production of interferon (IFN)–γ and tumor necrosis factor (TNF)–α by peripheral blood mononuclear cells (PBMC) of HIV-1–infected versus –uninfected patients with newly diagnosed pulmonary TB (PTB) was compared. Findings were correlated with cytokine profiles, clinical presentation, and expression of inducible nitric oxide (iNOS). Most HIV-1/PTB patients with a CD4 cell count of 200–500 cells/μL had high IFN-γ production and radiographic evidence of atypical PTB. Low IFN-γ production and radiographic evidence of reactivated PTB characterized both HIV-1/PTB patients with a CD4 cell count ⩾500 cells/μL and HIV-1–uninfected patients. TNF-α levels were similar in all HIV-1/PTB patients, regardless of CD4 cell count. Induction of iNOS in PBMC was low and was associated with low IFN-γ production. These data underscore the potential pathogenic role of macrophage-activating cytokines in TB in HIV-1–infected patients

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