<scp>HIV</scp>–<scp>TB</scp> co‐infection: mechanisms that drive reactivation of <i>Mycobacterium tuberculosis</i> in <scp>HIV</scp> infection

Ahmed, Asma; Rakshit, Sourav; Vyakarnam, Annapurna

doi:10.1111/odi.12390

Cited by 27 publications

(17 citation statements)

References 85 publications

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“…Recent evidence has indicated a substantial association between coronavirus-related Lower Respiratory Tract Infections (LRTIs) and increased risk of death in immune-compromised individuals [ 16 , 17 ]. At the same time, the depletion of CD4 T cells in HIV and latent TB-infection disrupts the integrity and architecture of TB granulomas in the lung, thus facilitating progression to active TB [ 18 – 20 ]. Similarly, TB promotes a microenvironment that facilitates the replication of HIV-1 via various mediators [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence

et al. 2020

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Background The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the twenty-first century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field. However, several gaps remain in the knowledge of the burden of COVID-19 on patients with TB and HIV. This study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB, to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management. Methods We conducted an electronic search of potentially eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and July, 2020 in which SARS-CoV, MERS-CoV and COVID-19 co-infected to HIV/TB or TB in adults. We screened titles, abstracts and full articles for eligibility. Descriptive and meta-analysis were done and results have been presented in graphs and tables. Results After removing 95 duplicates, 58 out of 437 articles were assessed for eligibility, of which 14 studies were included for descriptive analysis and seven studies were included in the meta-analysis. Compared to the descriptive analysis, the meta-analysis showed strong evidence that current TB exposure was high-risk COVID-19 group (OR 1.67, 95% CI 1.06–2.65, P = 0.03). The pooled of COVID-19/TB severity rate increased from OR 4.50 (95% CI 1.12–18.10, P = 0.03), the recovery rate was high among COVID-19 compared to COVID-19/TB irrespective of HIV status (OR 2.23, 95% CI 1.83–2.74, P < 0.001) and the mortality was reduced among non-TB group (P < 0.001). Conclusion In summary, TB was a risk factor for COVID-19 both in terms of severity and mortality irrespective of HIV status. Structured diagnostic algorithms and clinical management are suggested to improve COVID-19/HIV/TB or COVID-19/TB co-infections outcomes.

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Section: Introductionmentioning

confidence: 99%

Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence

et al. 2020

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“…Recent evidence has indicated a substantial association between coronavirus-related Lower Respiratory Tract Infections (LRTIs) and increased risk of death in immune-compromised individuals [16][17]. At the same time, the depletion of CD4 T cells in HIV and latent TB-infection disrupts the integrity and architecture of TB granulomas in the lung, thus facilitating progression to active TB [18][19][20]. Similarly, TB promotes a microenvironment that facilitates the replication of HIV-1 via various mediators [21].…”

Section: Introductionmentioning

confidence: 99%

Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence

Tamuzi

Birhanu

Shumba³

et al. 2020

Preprint

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Background: The triple burden of COVID-19, tuberculosis and human immunodeficiency virus is one of the major global health challenges of the 21st century. In high burden HIV/TB countries, the spread of COVID-19 among people living with HIV is a well-founded concern. A thorough understanding of HIV/TB and COVID-19 pandemics is important as the three diseases interact. This may clarify HIV/TB/COVID-19 as a newly related field. However, several gaps remain in the knowledge of the burden of COVID-19 on patients with TB and HIV. This study was conducted to review different studies on SARS-CoV, MERS-CoV or COVID-19 associated with HIV/TB co-infection or only TB, to understand the interactions between HIV, TB and COVID-19 and its implications on the burden of the COVID-19 among HIV/TB co-infected or TB patients, screening algorithm and clinical management.Methods: We conducted an electronic search of potentially eligible studies published in English in the Cochrane Controlled Register of Trials, PubMed, Medrxiv, Google scholar and Clinical Trials Registry databases. We included case studies, case series and observational studies published between January, 2002 and July, 2020 in which SARS-CoV, MERS-CoV and COVID-19 co-infected to HIV/TB or TB in adults. We screened titles, abstracts and full articles for eligibility. Descriptive and meta-analysis were done and results have been presented in graphs and tables.Results: After removing 95 duplicates, 58 out of 437 articles were assessed for eligibility, of which 14 studies were included for descriptive analysis and seven studies were included in the meta-analysis. Compared to the descriptive analysis, the meta-analysis showed strong evidence that current TB exposure was high-risk COVID-19 group (OR 1.67, 95% CI 1.06-2.65, P= 0.03). The pooled of COVID-19/TB severity rate increased from OR 4.50 (95% CI 1.12-18.10, P=0.03), the recovery rate was high among COVID-19 compared to COVID-19/TB irrespective of HIV status (OR 2.23, 95% CI 1.83-2.74, P < 0.001) and the mortality was reduced among non-TB group (P<0.001).Conclusion: In summary, TB was a risk factor for COVID-19 both in terms of severity and mortality irrespective of HIV status. Structured diagnostic algorithms and clinical management are suggested to improve COVID-19/HIV/TB or COVID-19/TB co-infections outcomes.

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“…The functionally heterogeneous CD4 + T cell compartment in the body is known to be important for immunity to TB [ 4 ]. Loss of CD4 + T cells, induced by HIV infection, is recognised to increase susceptibility to TB and TB incidence globally [ 5 ]. Within the CD4 + T cell compartment, Th1 effector cytokines IFNγ and IL-12 are particularly important.…”

Section: Introductionmentioning

confidence: 99%

Circulating HLA-DR+CD4+ effector memory T cells resistant to CCR5 and PD-L1 mediated suppression compromise regulatory T cell function in tuberculosis

et al. 2018

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Chronic T cell activation is a hallmark of pulmonary tuberculosis (PTB). The mechanisms underpinning this important phenomenon are however, poorly elucidated, though known to rely on control of T effector cells (Teff) by regulatory T cells (Treg). Our studies show that circulating natural Treg cells in adults with PTB preserve their suppressive potential but Teff cells from such subjects are resistant to Treg-mediated suppression. We found this to be due to expansion of an activated Teff subset identified by Human Leukocyte Antigen (HLA)-DR expression. Sensitivity to suppression was restored to control levels by depletion of this subset. Comparative transcriptome analysis of Teff cells that contain HLA-DR+ cells versus the fraction depleted of this population identified putative resistance mechanisms linked to IFNG, IL17A, IL22, PD-L1 and β-chemokines CCL3L3, CCL4 expression. Antibody blocking experiments confirmed HLA-DR+ Teff cells, but not the fraction depleted of HLA-DR+ effectors, to be resistant to Treg suppression mediated via CCR5 and PD-L1 associated pathways. In the presence of HLA-DR+ Teff cells, activation of NFκB downstream of CCR5 and PD-L1 was perturbed. In addition, HLA-DR+ Teff cells expressed significantly higher levels of Th1/Th17 cytokines that may regulate Treg function through a reciprocal counter-balancing relationship. Taken together, our study provides novel insight on how activated HLA-DR+CD4+ T cells may contribute to disease associated inflammation by compromising Treg-mediated suppression in PTB.

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HIV–TB co‐infection: mechanisms that drive reactivation of Mycobacterium tuberculosis in HIV infection

Cited by 27 publications

References 85 publications

Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence

Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence

Implications of COVID-19 in high burden countries for HIV/TB: A systematic review of evidence

Circulating HLA-DR+CD4+ effector memory T cells resistant to CCR5 and PD-L1 mediated suppression compromise regulatory T cell function in tuberculosis

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