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Interaction between HIV and Mycobacterium tuberculosis: HIV-1-induced CD4 T-cell depletion and the development of active tuberculosis

Geldmacher, Christofa,b; Zumla, Alimuddinc; Hoelscher, Michaela,b

Current Opinion in HIV and AIDS: May 2012 - Volume 7 - Issue 3 - p 268–274
doi: 10.1097/COH.0b013e3283524e32
CO-INFECTION OF POVERTY RELATED DISEASES WITH WORMS: Edited by Alison Elliott and Maria Yazdanbakhsh

Purpose of review HIV infection is the main driver of the HIV/tuberculosis (TB) syndemic in southern Africa since the early 1990s, when HIV infection rates started to increase exponentially and TB incidence rates quadruplet simultaneously. Here, we discuss pathogenic mechanisms of HIV-induced CD4 T-cell depletion and their potential impact on immune control of Mycobacterium tuberculosis.

Recent findings Depletion of effector memory CD4 T cells from the air–tissue interphase, their dysfunctional regeneration and the preferential depletion of MTB-specific CD4 T cells from circulation and from the air–tissue interphase might be key factors for the increased susceptibility to develop active TB after HIV infection.

Summary Early initiation of antiretroviral therapy or the development of an efficacious HIV vaccine would be the best options to reduce morbidity and mortality associated with the HIV/TB syndemic.

aDivision of Infectious Diseases and Tropical Medicine

bNational Center for Infectious Diseases of Germany, Medical Center of the University of Munich, Germany

cCentre for Infectious Diseases and International Health, Department of Infection, University College London Medical School, London, UK

Correspondence to Christof Geldmacher, Division of Infectious Diseases and Tropical Medicine, Leopoldstr. 5, 80802 Munich, Germany. Tel: +49 89 2180 17614; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.