Interferon-γ and tumour necrosis factor-α production by CD4+ T and CD8+ T lymphocytes in AIDS patients with tuberculosis


Reinaldo Salomao MD, PhD, Immunology Laboratory, Division of Infectious Diseases, Universidade Federal de Sao Paulo − UNIFESP, Rua Pedro de Toledo 781, 15 andar, 04039–032 − São Paulo, Brazil.


Tuberculosis (TB) is usually more severe in HIV-infected patients, and the immune derangement found in co-infected patients may differ from that in each isolated disease. Following mitogen stimulation of peripheral blood mononuclear cells (PBMC), interferon (IFN)-γ and tumour necrosis factor (TNF)-α production was evaluated in T cells by flow cytometry, and in culture supernatants by enzyme-linked immunosorbent assay (ELISA) in 33 individuals: 11 AIDS patients with tuberculosis, six asymptomatic HIV-1-infected patients, eight patients with tuberculosis and eight healthy controls. The proportion of CD4+ T lymphocytes expressing IFN-γ did not differ between the groups, whereas a trend towards increased proportions of TNF-α-expression in CD4+ T cells was observed in the TB compared to the HIV group, while intermediate values were observed in co-infected patients. Detection of IFN-γ and TNF-α in CD8+ T lymphocytes was higher in TB than in HIV individuals. Co-infected patients presented intermediate values for IFN-γ, while TNF-α detection was similar to that in HIV mono-infection. In conclusion, the proportion of T cells expressing IFN-γ was relatively preserved in co-infected patients compared to TB patients, while the percentage of T cells expressing TNF-α was decreased, mainly in CD8+ T lymphocytes. However, the marked reduction in T lymphocyte numbers in co-infected patients led to a striking reduction of both cytokines in PBMC supernatants, a finding that is consistent with the impaired response to Mycobacterium tuberculosis.