Birku, Mahlet (2014) Mycobacterium Tuberculosis-specific Functional Immune Response in Pregnant Women with Human Immunodeficiency Virus and Latent Tuberculosis Co -Infection. Masters thesis, Addis Ababa University.
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Abstract
Background: Immunity to tuberculosis is suppressed due to HIV co-infection and this suppression could further be enhanced by pregnancy. However, no study has evaluated tuberculosis specific immune response of pregnant women with HIV and latent tuberculosis coinfection. Objective: To determine M. tuberculosis specific functional immune response in pregnant women with HIV and Latent Tuberculosis Co-Infection Method: A cross-sectional study was conducted in five hospitals and two health centers in Addis Ababa, Ethiopia from April 2013 to July 2014. Blood was collected from 267 women with no active TB (86 HIV positive pregnant, 74 HIV negative pregnant and 107 HIV positive nonpregnant women). TST and QFT-GIT tests were done to screen latent tuberculosis. Peripheral Blood Mononuclear Cells (PBMCs) were isolated and IFN-γ, IL-4 and IL-10 ELISPOT were performed in stimulation with -CD3, PPD and ESAT-6/CFP-10. Plasma was separeted from latent tuberculosis infected and uninfected women to measure TB specific IgG using ELISA. Result: HIV negative pregnant women had higher proportion of QFT-GIT positivity (29.7%) than HIV positive pregnant (19%) and HIV positive non-pregnant women (23.4%). The agreement between TST and QFT-GIT ranges between substantial to excellent. The median frequency of IFN-γ secreting cells to PPD and ESAT-6/ CFP-10 were not significantly different between HIV positive and HIV negative pregnant women. However, HIV positive non-pregnant women had significantly higher IFN-γ secreting cells to PPD and ESAT-6/ CFP-10 than HIV positive pregnant women, p = 0.0407 and p = 0.0438, respectively while IL-4 response didn’t show significant difference. HIV positive pregnant women had more IL-10 in response to PPD and ESAT-6/CFP-10 than HIV positive non-pregnant control, p= 0.0206 and p=0.0024, respectively. The frequencies of tuberculosis specific IFN-, IL-4 and IL-10 secreting cells were not significantly related with CD4+ T cells count. The median concentration of IgG was not significantly different between latently infected HIV positive and HIV negative pregnant women. Conclusion and recommendation: Our results support the hypothesis that HIV positive pregnant women are at significant risk of failing to control TB infection due to suppression of Th1 response. However, their antibody response remains intact. Need more prospective studies to assess risk of HIV postive pregnancy in post partum tuberculosis, evaluate performance of TST and QFT-GIT in HIV postive pregnant women.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | TST, QFT-GIT, ELISPOT, IFN-, IL-4, IL-10, CD4+ T cells, pregnancy |
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Africana |
| Depositing User: | Emmanuel Ndorimana |
| Date Deposited: | 19 Oct 2018 06:05 |
| Last Modified: | 19 Oct 2018 06:05 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/6960 |
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