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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.

Original publication

DOI

10.1016/s0035-9203(03)90096-4

Type

Journal article

Journal

Trans R Soc Trop Med Hyg

Publication Date

07/2003

Volume

97

Pages

477 - 480

Keywords

AIDS-Related Opportunistic Infections, Adult, Disease Progression, Eosinophilia, Female, Follow-Up Studies, HIV Infections, HIV-1, Humans, Male, Risk Factors, Schistosomiasis, Social Class, Tuberculosis