Eosinophilia and progression to active tuberculosis in HIV-1-infected Ugandans

Publication Date: 
Tuesday, July 1, 2003
Elliott AM, Kyosiimire J, Quigley M, Nakiyingi J, Watera C, Brown M, Joseph S, French N, Gilks C and Whitworth JAG

It has been suggested that type 1 immune responses protect against tuberculosis (TB), while type 2 responses, such as those induced by helminths, may suppress protective responses and increase susceptibility to TB. Factors associated with progression to active TB were investigated in a cohort of HIV-1-infected Ugandan adults, a group at high risk of TB. High rates of subsequent progression to active TB were associated with eosinophil counts > or = 0.4 x 10(9)/L at enrolment. Eosinophilia at enrolment was associated with male gender, low socio-economic status, high CD4+ T cell counts, and schistosomiasis, but adjusting for these factors did not explain the association of eosinophilia with progression to active TB (adjusted rate ratio = 2.76, P = 0.004). Eosinophilia is most likely to be indicative of a type 2 immune response induced by helminth infection in this Ugandan cohort, but the mechanism of the observed association between eosinophilia and risk of TB remains to be determined.

Transactions of the Royal Society of Tropical Medicine and Hygiene
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