Hepatitis C Virus Affects Tuberculosis-Specific T Cells in HIV-Negative Patients
Hepatitis C Virus Affects Tuberculosis-Specific T Cells in HIV-Negative Patients
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DOI：
10.3390/v12010101
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发表时间：
2020-01-01
期刊：
影响因子：
4.7
通讯作者：
Salama, Eman H.
中科院分区：
文献类型：
--
作者：
El-Mokhtar, Mohamed Ahmed;Elgendy, Sherein G.;Salama, Eman H.
结核病（TB）和丙型肝炎病毒（HCV）感染在同一患者中的发生提出了独特的临床挑战。在TB+/HCV+患者中，HCV感染对TB免疫应答的影响仍然研究不足。本研究旨在评估HCV对合并感染患者T细胞介导的结核病免疫应答的影响。对64例活动性结核感染患者进行了HCV合并感染筛查。通过流式细胞术评估TB单感染患者、TB/HCV合并感染患者和健康对照者中TB特异性CD 4（+）T细胞上免疫活化标志物IFN-γ、CD 38和HLA-DR的表达。使用ELISA测量IL-2、IL-4、IFN-gamma、TNF-alpha和IL-10水平。记录两组患者治疗结束时对抗结核治疗的反应。与TB单感染患者和对照组相比，在TB/HCV合并感染患者中检测到的CD 4（+）IFN-γ（+）CD 38（+）和CD 4（+）IFN-γ（+）HLA-DR+ T细胞水平显著降低。TB+/HCV+合并感染患者血清IL-10水平较高。在TB+/HCV+患者中，TB特异性活化T细胞亚群的基线频率不能预测抗结核治疗的应答。我们的结论是，TB/HCV感染个体中TB特异性CD 4（+）T细胞的不同亚群在早期HCV感染中部分受损。这与血清IL-10水平升高相结合。这种免疫调节可能是HCV/TB合并感染患者疾病进展的一个强有力的危险因素。
The occurrence of tuberculosis (TB) and hepatitis C virus (HCV) infections in the same patient presents a unique clinical challenge. The impact of HCV infection on the immune response to TB remains poorly investigated in TB+/HCV+ patients. This study was conducted to evaluate the impact of HCV on the T-cell-mediated immune response to TB in coinfected patients. Sixty-four patients with active TB infections were screened for coinfection with HCV. The expression of immune activation markers IFN-gamma, CD38, and HLA-DR on TB-specific CD4(+) T cells was evaluated by flow cytometry in TB-monoinfected patients, TB/HCV-coinfected patients, and healthy controls. IL-2, IL-4, IFN-gamma, TNF-alpha, and IL-10 levels were measured using ELISA. The end-of-treatment response to anti-TB therapy was recorded for both patient groups. Significantly lower levels of CD4(+)IFN-gamma(+)CD38(+) and CD4(+)IFN-gamma(+)HLA-DR+ T cells were detected in TB/HCV-coinfected patients compared to TB monoinfected patients and controls. TB+/HCV+-coinfected patients showed higher serum levels of IL-10. The baseline frequencies of TB-specific activated T-cell subsets did not predict the response to antituberculous therapy in TB+/HCV+ patients. We concluded that different subsets of TB-specific CD4(+) T cells in TB/HCV-infected individuals are partially impaired in early-stage HCV infection. This was combined with increased serum IL-10 level. Such immune modulations may represent a powerful risk factor for disease progression in patients with HCV/TB coinfection.