Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis

Geremew, Demeke; Melku, Mulugeta; Endalamaw, Aklilu; Woldu, Berhanu; Fasil, Alebachew; Negash, Markos; Baynes, Habtamu Wondifraw; Geremew, Habtamu; Teklu, Takele; Deressa, Tekalign; Tessema, Belay; Sack, Ulrich

doi:10.1186/s12879-020-05040-4

Cited by 23 publications

(26 citation statements)

References 39 publications

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“…The overall and subgroup analysis of random effects model with 95% CIs were calculated and demonstrated using a forest plot. Nevertheless, for studies with small (near 0) or large (near 1) prevalence, the inverse variance method was not stable and hence, we used Freeman Tukey arcsine methodology to address stabilizing variances as evidenced elsewhere [ 12 , 16 , 17 ]. Syphilis-HIV co-infection and the effect of selected predictor variables including marital status, previous history of multiple sexual partner, and previous history of STI on syphilis prevalence was analyzed using separate categories of meta-analysis.…”

Section: Methodsmentioning

confidence: 99%

Sero-prevalence of syphilis and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

Geremew

2021

Syst Rev

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Background Syphilis remained a major cause of reproductive morbidity and poor pregnancy outcomes in developing countries. Previously, studies showed inconsistent results and failed to show the actual picture of the diseases in Ethiopia. Thus, the aim of this meta-analysis was, first, to determine the updated pooled prevalence of syphilis among pregnant women in Ethiopia and, second, to assess its associated factors. Methods A comprehensive search was made on PubMed, Google scholar, Science Direct, and African Journals Online databases to identify relevant articles. A random effects model was used to estimate pooled syphilis prevalence and odds ratio (OR) with the respective 95% confidence intervals (CIs) using STATA 14 statistical software. I2 statistics and Egger’s regression test in conjunction with funnel plot was used to determine heterogeneity and publication bias among included studies respectively. Result We identified 13 suitable studies in this analysis. Accordingly, the pooled prevalence of syphilis among pregnant women in Ethiopia was 2.32% (95% CI, 1.68–2.97). Specifically, syphilis prevalence was 2.53% (95% CI, 1.92–3.14%) and 1.90% (95% CI, 0.40–3.40%) as per the treponemal and non-ytreponemal diagnostic test, respectively. On the other hand, regional analysis indicated that 4.06% (95% CI, 2.86–5.26) in Southern Nations Nationalities and Peoples (SNNP), 2.16% (95% CI, 1.57–2.75) in Amhara and 1.46% (95% CI, 0.69–2.23) in Oromia region. Being married (OR, 0.37 (95% CI, 0.12–0.91%)) was less likely to develop syphilis. On the other hand, women with history of multiple sexual partner (OR, 2.98 (95% CI, 1.15–7.70)) and women with history of previous sexually transmitted infection (STI) (OR, 4.88 (95% CI, 1.35–17.62)) have higher risk to develop syphilis. Besides, the pooled syphilis-HIV coinfection was 0.80% (95% CI, 0.60–1.01%). Conclusion This study provides evidence of relatively high prevalence of syphilis among pregnant women in Ethiopia. Therefore, it is recommended to further ramping up of current intervention measures to prevent future generations. Systematic review registration PROSPERO CRD42020211650

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Section: Methodsmentioning

confidence: 99%

Sero-prevalence of syphilis and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

Geremew

2021

Syst Rev

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“…These cells play an integral role in adaptive immunity as well as providing “memory”, to fight off repeat infections more effectively. Opportunistic infections like HIV and Mtb infections have been shown to rely heavily on CD4+ T-cells, which serve as predictors for risk of infections [ 78 ]. Both Mtb and SARS-CoV-2 infections invade lung pneumocytes.…”

Section: Resultsmentioning

confidence: 99%

Recent Developments in the Understanding of Immunity, Pathogenesis and Management of COVID-19

Yegiazaryan

Abnousian

Alexander

et al. 2022

IJMS

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Coronaviruses represent a diverse family of enveloped positive-sense single stranded RNA viruses. COVID-19, caused by Severe Acute Respiratory Syndrome Coronavirus-2, is a highly contagious respiratory disease transmissible mainly via close contact and respiratory droplets which can result in severe, life-threatening respiratory pathologies. It is understood that glutathione, a naturally occurring antioxidant known for its role in immune response and cellular detoxification, is the target of various proinflammatory cytokines and transcription factors resulting in the infection, replication, and production of reactive oxygen species. This leads to more severe symptoms of COVID-19 and increased susceptibility to other illnesses such as tuberculosis. The emergence of vaccines against COVID-19, usage of monoclonal antibodies as treatments for infection, and implementation of pharmaceutical drugs have been effective methods for preventing and treating symptoms. However, with the mutating nature of the virus, other treatment modalities have been in research. With its role in antiviral defense and immune response, glutathione has been heavily explored in regard to COVID-19. Glutathione has demonstrated protective effects on inflammation and downregulation of reactive oxygen species, thereby resulting in less severe symptoms of COVID-19 infection and warranting the discussion of glutathione as a treatment mechanism.

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“…Immunity to M. tuberculosis requires CD4 T cells and IFN-γ to activate effector functions within infected macrophages. This is supported by the extreme susceptibility of Ifng -/and Rag1 -/mice, the high co-morbidity between TB and low CD4 T cell counts caused by AIDS, and the ability of recombinant IFN-γ to control bacterial growth in mouse and human macrophages in vitro [1][2][3][4][5][6]32]. However, while IFN-γ production by CD4 T cells is most likely necessary for full control of infection, it has become clear that IFN-γ is a poor biomarker for effective CD4 T cell immunity to TB and that CD4 T cells are capable of controlling infection even in the absence of IFN-γ [1,7,33].…”

Section: Discussionmentioning

confidence: 99%

IFN-γ-independent control of M. tuberculosis requires CD4 T cell-derived GM-CSF and activation of HIF-1α

et al. 2022

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The prevailing model of protective immunity to tuberculosis is that CD4 T cells produce the cytokine IFN-γ to activate bactericidal mechanisms in infected macrophages. Although IFN-γ-independent CD4 T cell based control of M. tuberculosis infection has been demonstrated in vivo it is unclear whether CD4 T cells are capable of directly activating macrophages to control infection in the absence of IFN-γ. We developed a co-culture model using CD4 T cells isolated from the lungs of infected mice and M. tuberculosis-infected murine bone marrow-derived macrophages (BMDMs) to investigate mechanisms of CD4 dependent control of infection. We found that even in the absence of IFN-γ signaling, CD4 T cells drive macrophage activation, M1 polarization, and control of infection. This IFN-γ-independent control of infection requires activation of the transcription factor HIF-1α and a shift to aerobic glycolysis in infected macrophages. While HIF-1α activation following IFN-γ stimulation requires nitric oxide, HIF-1α-mediated control in the absence of IFN-γ is nitric oxide-independent, indicating that distinct pathways can activate HIF-1α during infection. We show that CD4 T cell-derived GM-CSF is required for IFN-γ-independent control in BMDMs, but that recombinant GM-CSF is insufficient to control infection in BMDMs or alveolar macrophages and does not rescue the absence of control by GM-CSF-deficient T cells. In contrast, recombinant GM-CSF controls infection in peritoneal macrophages, induces lipid droplet biogenesis, and also requires HIF-1α for control. These results advance our understanding of CD4 T cell-mediated immunity to M. tuberculosis, reveal important differences in immune activation of distinct macrophage types, and outline a novel mechanism for the activation of HIF-1α. We establish a previously unknown functional link between GM-CSF and HIF-1α and provide evidence that CD4 T cell-derived GM-CSF is a potent bactericidal effector.

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Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis

Cited by 23 publications

References 39 publications

Sero-prevalence of syphilis and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

Sero-prevalence of syphilis and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

Recent Developments in the Understanding of Immunity, Pathogenesis and Management of COVID-19

IFN-γ-independent control of M. tuberculosis requires CD4 T cell-derived GM-CSF and activation of HIF-1α

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