The Immune Response to Mycobacterium tuberculosis in HIV-1-Coinfected Persons

Globally, about 36.7 million people were living with HIV infection at the end of 2015. The most frequent infection co-occurring with HIV-1 is Mycobacterium tuberculosis -374,000 deaths per annum are attributable to HIV-tuberculosis, 75% of those occurring in Africa. HIV-1 infection increases the ris...

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Bibliographic Details
Published in:Annual review of immunology 2018-04, Vol.36 (1), p.603-638
Main Authors: Esmail, Hanif, Riou, Catherine, du Bruyn, Elsa, Lai, Rachel Pei-Jen, Harley, Yolande X.R, Meintjes, Graeme, Wilkinson, Katalin A, Wilkinson, Robert J
Format: Article
Language:English
Subjects:
Animals
Antiretroviral Therapy, Highly Active
Antitubercular Agents - pharmacology
Antitubercular Agents - therapeutic use
Coinfection
Disease Progression
drug therapy
Genetic Variation
HIV Infections - diagnosis
HIV Infections - immunology
HIV Infections - therapy
HIV Infections - virology
HIV-1 - genetics
HIV-1 - immunology
HIV-1 infection
Host-Pathogen Interactions - immunology
Humans
immune response
Immunity
Mycobacterium tuberculosis - immunology
pathogenesis
tuberculosis
Tuberculosis - diagnosis
Tuberculosis - immunology
Tuberculosis - microbiology
Tuberculosis - therapy
Virus Replication
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Summary:Globally, about 36.7 million people were living with HIV infection at the end of 2015. The most frequent infection co-occurring with HIV-1 is Mycobacterium tuberculosis -374,000 deaths per annum are attributable to HIV-tuberculosis, 75% of those occurring in Africa. HIV-1 infection increases the risk of tuberculosis by a factor of up to 26 and alters its clinical presentation, complicates diagnosis and treatment, and worsens outcome. Although HIV-1-induced depletion of CD4 + T cells underlies all these effects, more widespread immune deficits also contribute to susceptibility and pathogenesis. These defects present a challenge to understand and ameliorate, but also an opportunity to learn and optimize mechanisms that normally protect people against tuberculosis. The most effective means to prevent and ameliorate tuberculosis in HIV-1-infected people is antiretroviral therapy, but this may be complicated by pathological immune deterioration that in turn requires more effective host-directed anti-inflammatory therapies to be derived.
ISSN:0732-0582
1545-3278
DOI:10.1146/annurev-immunol-042617-053420