Michael NL, Whalen C, Johnson J, Nsubuga P, Hom D, Mugerwa R, Birx D, Ellner J; International Conference on AIDS.

Int Conf AIDS. 1996 Jul 7-12; 11: 27 (abstract no. We.B.414).

Division of Retrovirology, WRAIR, Rockville, MD. Fax: (301)762-4177. E-mail: nmichael@hiv.hjf.org.

Objective: To analyze the impact of active pulmonary tuberculosis on HIV-1 RNA load in subjects prior to and following tuberculosis therapy. Methods: Twenty HIV-1 seropositive cases of culture confirmed active pulmonary TB were pair-matched (age, gender, CD4 count, and DTH response) to twenty HIV-1 seropositive controls from two placebo arms of a TB preventive therapy trial being conducted in Kampala, Uganda. Baseline and 6 month follow-up serum specimens were subjected to viral RNA quantitation using the Roche Amplicor assay. TB cases, randomly selected from a ongoing TB natural history study, received 6 months of standard short course combination anti-TB chemotherapy during follow-up. Results: Seven patients had viral loads below the level of detection of the assay. These subjects, and their cognate pair members, were censured for analysis. Paired analysis of the remaining 13 case-control pairs revealed a 5.2-fold greater median RNA load (copies/ml) at baseline in TB cases (5,335) versus matched controls (1,015) (p = .116, Wilcoxon) but a 70-fold greater median RNA load at 6 month follow-up in TB cases (37,285) versus controls (539) (p = .03, Wilcoxon) despite evidence for adequate antituberculous therapy. Conclusions: Levels of serum HIV-1 RNA viral load were higher in patients with active pulmonary TB versus matched HIV+ non-TB controls and this difference increased during the follow-up period. These data suggest that mycobacterial infection enhances HIV replication. The rise in viral load seen in the cases following therapy despite what should have been adequate chemotherapy suggests that TB may permanently accelerate the natural history of HIV disease. Additional case control pairs are under study to increase the statistical power of this study.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• CD4 Lymphocyte Count
• Case-Control Studies
• Drug Therapy, Combination
• HIV
• HIV Infections
• HIV Seronegativity
• HIV Seropositivity
• HIV-1
• Humans
• Longitudinal Studies
• RNA, Viral
• Tuberculosis
• Tuberculosis, Pulmonary
• Uganda
• Viral Load
• immunology
• organization & administration

Other ID:

• 96923217

UI: 102219116

From Meeting Abstracts