HIV infection is a major risk factor predisposing for Mycobacterium tuberculosis infection and progression to active tuberculosis (TB). As host immune response defines the course of infection, we aimed to identify immuno-endocrine changes over six-months of anti-TB chemotherapy in HIV+ people. Plasma levels of cortisol, DHEA and DHEA-S, percentages of CD4+ regulatory T cell subsets and number of IFN-γ-secreting cells were determined. Several cytokines, chemokines and C-reactive protein levels were measured. Results were correlated with clinical parameters as predictors of infection resolution and compared to similar data from HIV+ individuals, HIV-infected persons with latent TB infection and healthy donors. Throughout the course of anti-TB/HIV treatment, DHEA and DHEA-S plasma levels raised while cortisol diminished, which correlated to predictive factors of infection resolution. Furthermore, the balance between cortisol and DHEA, together with clinical assessment, may be considered as an indicator of clinical outcome after anti-TB treatment in HIV+ individuals. Clinical improvement was associated with reduced frequency of unconventional Tregs, increment in IFN-γ-secreting cells, diminution of systemic inflammation and changes of circulating cytokines and chemokines. This study suggests that the combined anti-HIV/TB therapies result in partial restoration of both, immune function and adrenal hormone plasma levels.

中文翻译：

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结核分枝杆菌合并感染 HIV-1 患者整个结核病治疗过程中的免疫变异及其与肾上腺激素变化的关系

HIV 感染是导致结核分枝杆菌感染和进展为活动性结核病 (TB) 的主要危险因素。由于宿主免疫反应定义了感染过程，我们旨在确定 HIV+ 人群在六个月的抗结核化疗期间的免疫内分泌变化。测定了皮质醇、DHEA 和 DHEA-S 的血浆水平、CD4+ 调节性 T 细胞亚群的百分比和 IFN-γ 分泌细胞的数量。测量了几种细胞因子、趋化因子和 C 反应蛋白水平。结果与临床参数相关，作为感染消退的预测因子，并与来自 HIV+ 个体、潜伏结核病感染的 HIV 感染者和健康供体的类似数据进行了比较。在整个抗 TB/HIV 治疗过程中，DHEA 和 DHEA-S 血浆水平升高，而皮质醇降低，这与感染解决的预测因素相关。此外，皮质醇和 DHEA 之间的平衡以及临床评估可被视为 HIV+ 个体抗结核治疗后临床结果的指标。临床改善与非常规 Treg 频率降低、IFN-γ 分泌细胞增加、全身炎症减少以及循环细胞因子和趋化因子的变化有关。这项研究表明，联合抗 HIV/TB 疗法导致免疫功能和肾上腺激素血浆水平的部分恢复。临床改善与非常规 Treg 频率降低、IFN-γ 分泌细胞增加、全身炎症减少以及循环细胞因子和趋化因子的变化有关。这项研究表明，联合抗 HIV/TB 疗法导致免疫功能和肾上腺激素血浆水平的部分恢复。临床改善与非常规 Treg 频率降低、IFN-γ 分泌细胞增加、全身炎症减少以及循环细胞因子和趋化因子的变化有关。这项研究表明，联合抗 HIV/TB 疗法导致免疫功能和肾上腺激素血浆水平的部分恢复。