Immune response to Mycobacterium tuberculosis in children and adolescents infected with Human Immunodeficiency Virus

Abstract

The epidemiological importance of Mycobacterium tuberculosis infection has increased in recent decades due to the high circulation of bacilli in the world population. After being in contact with the bacillus, the population at higher risk of developing the disease comprises children and adolescents infected with HIV, when compared to healthy subjects. After exposure, these patients may develop active disease or latent infection that can later be reactivated in tuberculosis. In order to characterize the cellular immune response to M. tuberculosis in HIV-infected pediatric patients, this study proposes to assess the proliferative response of lymphocyte subpopulations and cytokine production of Th-1, Th-2 and Th-17 axes. Thus, 23 children and adolescents infected with HIV, between 10 and 22 years old, followed at Pediatrics Immunodeficiency Outpatient Unit at the State University of Campinas Hospital will be included. The control group will consist of 23 students from the Faculty of Medical Sciences of the State University of Campinas, between 18 and 25 years old, followed by the Community Health Center at the State University of Campinas (CECOM), referred for routine examination before their insertion in the hospital environment. The proliferation of CD4 T cells, CD8 T cells, gamma-delta T cells and cytokine production will be assessed in a culture of peripheral blood mononuclear cells stimulated with M. bovis and M. tuberculosis lysates and M. tuberculosis antigen ESAT-6. Associations between cell proliferation, cytokine production, tuberculin test and clinical variables at the HIV-infected patients, as well as the immune response difference between cases and controls exposed to mycobacterial antigens, will be evaluated. (AU)