Document 0870
 DOCN  M9480870
 TI    Serum markers of immune activation in HIV-associated pulmonary
       tuberculosis.
 DT    9410
 AU    Wallis R; Helfand M; Vjecha M; Whalen C; Mugerwa R; Okwera A; Ellner J;
       Case Western Reserve University, Cleveland, Ohio.
 SO    Abstr Gen Meet Am Soc Microbiol. 1994;94:190 (abstract no. U-99). Unique
       Identifier : AIDSLINE ASM94/94313075
 AB    Survival is shortened in HIV-infected patients with tuberculosis (TB) as
       compared to CD4-matched HIV-infected controls. We measured serum markers
       of immune activation in HIV-infected patients beginning treatment for
       pulmonary TB in Kampala, Uganda. Patients were followed for 16 months or
       until death. Initial levels of neopterin, beta 2 microglobulin, and
       receptors to TNF alpha and IL-2 were significantly higher in those who
       died: TABULAR DATA, SEE ABSTRACT VOLUME. These parameters did not
       correlate with X-ray findings as to extent location, or cavitary nature
       of disease. The markers did not change significantly during the first 2
       months of therapy in either survivors or non-survivors, not did they
       predict radiographic or microbiologic response to therapy or relapse.
       This suggests that mortality in HIV-associated tuberculosis may be more
       closely related to stage and/or progression of HIV disease rather than
       to progressive tuberculosis. Inasmuch as serum levels of receptors for
       IL-2 and TNF alpha parallel production of these cytokines in vivo, and
       both cytokines promote HIV expression in vitro, increased production of
       cytokines may provide mechanism for acceleration of HIV disease in
       patients with tuberculosis.
 DE    AIDS-Related Opportunistic Infections/*BLOOD/IMMUNOLOGY/MORTALITY
       Biological Markers/BLOOD  Biopterin/*ANALOGS & DERIVATIVES/BLOOD
       Comparative Study  Human  Predictive Value of Tests  Prognosis
       Receptors, Interleukin-2/*ANALYSIS  Receptors, Tumor Necrosis
       Factor/*ANALYSIS  Survival Rate  Tuberculosis,
       Pulmonary/*BLOOD/COMPLICATIONS/MORTALITY  MEETING ABSTRACT

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