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

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 97; no. 4; pp. 477 - 480
• Main Authors: Elliott, Alison M., Kyosiimire, Jacqueline, Quigley, Maria A., Nakiyingi, Jessica, Watera, Christine, Brown, Michael, Joseph, Sarah, French, Neil, Gilks, Charles F., Whitworth, James A.G.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.07.2003; Royal Society of Tropical Medicine and Hygiene; Elsevier
• Subjects: Adult; AIDS-Related Opportunistic Infections - complications; Bacterial diseases; Biological and medical sciences; Disease Progression; eosinophilia; Eosinophilia - complications; Female; Follow-Up Studies; HIV; HIV Infections - complications; HIV-1; Human bacterial diseases; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Risk Factors; Schistosomiasis - complications; Social Class; tuberculosis; Tuberculosis - complications; Tuberculosis and atypical mycobacterial infections; Uganda; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Uganda; Africa; eosinophilia; Uganda; HIV; tuberculosis; Human; Immunopathology; HIV-1 virus; Retroviridae; AIDS; Hemopathy; Mycobacterial infection; Immune deficiency; Lentivirus; Eosinophilia; Infection; Virus; Tuberculosis; Viral disease; Bacteriosis; Tropical medicine; Human immunodeficiency virus
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/S0035-9203(03)90096-4

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 ⩾ 0.4 × 109/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.