Published in:
Open Access
01-12-2010 | Research article
High levels of T lymphocyte activation in Leishmania-HIV-1 co-infected individuals despite low HIV viral load
Authors:
Joanna R Santos-Oliveira, Carmem BW Giacoia-Gripp, Priscilla Alexandrino de Oliveira, Valdir S Amato, Jose Ângelo L Lindoso, Hiro Goto, Manoel P Oliveira-Neto, Marise S Mattos, Beatriz Grinsztejn, Mariza G Morgado, Alda M Da-Cruz
Published in:
BMC Infectious Diseases
|
Issue 1/2010
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Abstract
Background
Concomitant infections may influence HIV progression by causing chronic activation leading to decline in T-cell function. In the Americas, visceral (AVL) and tegumentary leishmaniasis (ATL) have emerged as important opportunistic infections in HIV-AIDS patients and both of those diseases have been implicated as potentially important co-factors in disease progression. We investigated whether leishmaniasis increases lymphocyte activation in HIV-1 co-infected patients. This might contribute to impaired cellular immune function.
Methods
To address this issue we analyzed CD4+ T absolute counts and the proportion of CD8+ T cells expressing CD38 in Leishmania/HIV co-infected patients that recovered after anti-leishmanial therapy.
Results
We found that, despite clinical remission of leishmaniasis, AVL co-infected patients presented a more severe immunossupression as suggested by CD4+ T cell counts under 200 cells/mm3, differing from ATL/HIV-AIDS cases that tends to show higher lymphocytes levels (over 350 cells/mm3). Furthermore, five out of nine, AVL/HIV-AIDS presented low CD4+ T cell counts in spite of low or undetectable viral load. Expression of CD38 on CD8+ T lymphocytes was significantly higher in AVL or ATL/HIV-AIDS cases compared to HIV/AIDS patients without leishmaniasis or healthy subjects.
Conclusions
Leishmania infection can increase the degree of immune system activation in individuals concomitantly infected with HIV. In addition, AVL/HIV-AIDS patients can present low CD4+ T cell counts and higher proportion of activated T lymphocytes even when HIV viral load is suppressed under HAART. This fact can cause a misinterpretation of these laboratorial markers in co-infected patients.