Incomplete restoration of Mycobacterium tuberculosis-specific-CD4 T cell responses despite antiretroviral therapy

Objectives: Despite antiretroviral therapy (ART), HIV-infected persons have increased risk of active tuberculosis (TB). PPD and combined ESAT-6 and CFP-10-specific-CD4 (EC-Sp-CD4) responses were examined over 96 weeks. Methods: HIV-infected, ART-naive Thai adults with CD4 T cell count ≤350cells/μL starting ART were assessed at baseline, wk4, 8, 12, 24, 48 and 96. PPD and EC-Sp-CD4 T cells were detected by CD25/CD134 co-expression after stimulation with antigens. Results: Fifty subjects were enrolled, 39 were male, median age 32 yrs, median baseline CD4 T cell count 186cells/μL and plasma HIV-viral-load 4.9log10copies/mL. Seventeen were TB-sensitised.At baseline, 25 had positive PPD and 15 had positive EC-Sp-CD4 response. CD4 T cell count