HIV-1 and the Mycobacterium tuberculosis granuloma: A systematic review and meta-analysis
File(s)
Published version
Author(s)
Diedrich, CR
O'Hern, J
Wilkinson, RJ
Type
Journal Article
Abstract
Infection with HIV-1 greatly increases the risk of active tuberculosis (TB). Although hypotheses suggest HIV-1 disrupts Mycobacterium tuberculosis (Mtb) granuloma function, few studies have examined this directly. The objective of this study was to determine what evidence exists about the effect HIV-1 co-infection has upon Mtb granulomas. A systematic search of PubMed, Web of Science, and Medline up to 20 March 2015 was conducted, to identify studies comparing Mtb-infected tissue from HIV-1 infected and uninfected persons, or HIV-1 infected persons with stratified peripheral CD4 T cell (pCD4) counts. We summarized findings that focused on how HIV-1 changes granuloma formation, bacterial presence, cellular composition, and cytokine production. Nineteen studies with a combined sample size of 899 persons were included. Although studies frequently were limited by variable or inadequately described definitions of outcomes and analytical methods, HIV-1 was found to be associated with increased bacillary load within Mtb-infected tissue. Reductions in pCD4 counts within co-infected persons associated with both poorer granuloma formation and higher bacterial load. The high degree of heterogeneity among studies combined with experimental limitations made it difficult to conclusively support previously published and prevalent hypotheses about HIV-1/Mtb co-infection granulomas. To elucidate the validity of these hypotheses we have described areas that can be improved in future studies in order to clarify the influence HIV-1 co-infection has upon the Mtb granuloma.
Date Issued
2016-03-10
Date Acceptance
2016-02-29
Citation
Tuberculosis, 2016, 98, pp.62-76
ISSN
1873-281X
Publisher
Elsevier
Start Page
62
End Page
76
Journal / Book Title
Tuberculosis
Volume
98
Copyright Statement
© 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND
license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Subjects
Science & Technology
Life Sciences & Biomedicine
Immunology
Microbiology
Respiratory System
Mycobacterium tuberculosis
Tuberculosis
Granuloma
HIV
AIDS
Tissue
Histology
HUMAN-IMMUNODEFICIENCY-VIRUS
LYMPH-NODE TUBERCULOSIS
IMMUNE-DEFICIENCY-SYNDROME
CD4 T-CELLS
INFECTED PATIENTS
PLEURAL TUBERCULOSIS
NEEDLE-ASPIRATION
PULMONARY TUBERCULOSIS
CLINICAL PRESENTATION
POSITIVE PATIENTS
11 Medical And Health Sciences
Publication Status
Published