Effects Of Mycobacterium Tuberculosis Infection On Viral Reservoirs In HIV Patients

Objective:To study the effects of mycobacterium tuberculosis infection on viral reservoirs in HIV patients.Methods: Thirty-five non-opportunistic and 30 opportunistic mycobacterium tuberculosis infection in HIV positive patients were retrospectively studied in Shanghai Public Health Center in the past 2 years.Eventually 25 non-opportunistic and 20opportunisticmycobacterium tuberculosis infection patients were recruited,Excluding lost cases.Whole-blood samples at baseline and after 1 year of anti-virus treatment were stored at-80 °C.Statistical analysis was performed on the baseline conditions of patients enrolled in the study,including gender,age,CD4,CD8,antiviral program,antiviral opportunity,HIV viral load,and anti-tuberculosis program.Triple therapy with tenofovir disoproxil fumarate,lamivudine and efavirenz/nevirapine was first-line antiviral therapies.The anti-tuberculosis treatment regimen contained isoniazid,rifampicin / rifabutin,ethambutol and pyrazinamid.At least 2 weeks after the initiation of anti-tuberculosis treatment,antiviral treatment would be started,and antiviral treatment for 1 year.Quantitative detection of HIV DNA(genotype-1)in the whole blood by fluorescent probe real-time PCR.Compared the size of HIV-1 reservoirs in non-opportunistic and opportunistic mycobacterium tuberculosis infection patients at baseline and after one year of antiviral therapy.Analyzed the effect of mycobacterium tuberculosis infection on the HIV virus reservoirs.Results:1)The baseline CD4 and CD8 were statistically different between the two groups.The CD4 of non-opportunistic and opportunistic mycobacterium tuberculosis infection patients were 260.90±149.44 cells/ul,and 61.85±65.05 cells/ul respectively(P=0.000).The CD8 of non-opportunistic and opportunistic mycobacterium tuberculosis infection patients were 772.80±427.17 cells/ul,and 425.30±269.13 cells/ul respectively(P=0.001).2)The HIV-1DNA of non-opportunistic and opportunistic mycobacteriumtuberculosis infection patients were 2.594±0.5176 log copies/106 cells,and 3.410±0.4344 log copies/106 cells at baseline,respectively(P<0.001).3)The baseline HIV-1DNA of non-opportunistic infection patients were2.594 ± 0.5176 log copies/106 cells,and 1.956±0.5951 log copies/106 cells,after one year of antiviral therapy,respectively,(P <0.0001).4)The baseline HIV-1DNA of opportunistic mycobacterium tuberculosisinfection patients were 3.410±0.4344 log copies/106 cells,and 2.974±0.4847 log copies/106 cells after one year of antiviral therapy,respectively(p=0.0161).5)Compared to the baseline,one year after antiviral treatment,the virus reservoir decreased by 10%~20% and-20%~20% in the non-opportunistic and opportunistic mycobacterium tuberculosis infection patients,respectively(P=0.0150).Conclusion:At baseline,mycobacterium tuberculosis infection leads to an increase in HIV virus reservoirs.There is a correlation between Mycobacterium tuberculosis infection and the clearance of viral reservoirs in HIV patients.Mycobacterium tuberculosis infection delays the decline of viral reservoirs in HIV patients.Mycobacterium tuberculosis infection in HIV patients affects the efficacy of antiviral therapy and functional healing of HIV.