Impact of Co-Infections and BCG Immunisation on Immune Responses among Household Contacts of Tuberculosis Patients in a Ugandan Cohort

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dc.contributor.authorBiraro, Irene A.
dc.contributor.authorEgesa, Moses
dc.contributor.authorToulza, Frederic
dc.contributor.authorLevin, Jonathan
dc.contributor.authorCose, Stephen
dc.contributor.authorJoloba, Moses
dc.contributor.authorSmith, Steven
dc.contributor.authorDockrell, Hazel M.
dc.contributor.authorKatamba, Achilles
dc.contributor.authorElliott, Alison M.
dc.date.accessioned2023-01-18T17:19:19Z
dc.date.available2023-01-18T17:19:19Z
dc.date.issued2014
dc.description.abstractTuberculosis incidence in resource poor countries remains high. We hypothesized that immune modulating co-infections such as helminths, malaria, and HIV increase susceptibility to latent tuberculosis infection (LTBI), thereby contributing to maintaining the tuberculosis epidemic. Methods: Adults with sputum-positive tuberculosis (index cases) and their eligible household contacts (HHCs) were recruited to a cohort study between May 2011 and January 2012. HHCs were investigated for helminths, malaria, and HIV at enrolment. HHCs were tested using the QuantiFERON-TB Gold In-Tube (QFN) assay at enrolment and six months later. Overnight whole blood culture supernatants from baseline QFN assays were analyzed for cytokine responses using an 11- plex Luminex assay. Associations between outcomes (LTBI or cytokine responses) and exposures (co-infections and other risk factors) were examined using multivariable logistic and linear regression models. Results: We enrolled 101 index cases and 291 HHCs. Among HHCs, baseline prevalence of helminths was 9% (25/291), malaria 16% (47/291), HIV 6% (16/291), and LTBI 65% (179/277). Adjusting for other risk factors and household clustering, there was no association between LTBI and any co-infection at baseline or at six months: adjusted odds ratio (95% confidence interval (CI); p-value) at baseline for any helminth, 1.01 (0.39–2.66; 0.96); hookworm, 2.81 (0.56–14.14; 0.20); malaria, 1.06 (0.48–2.35; 0.87); HIV, 0.74 (0.22–2.47; 0.63). HHCs with LTBI had elevated cytokine responses to tuberculosis antigens but co-infections had little effect on cytokine responses. Exploring other risk factors, Th1 cytokines among LTBIpositive HHCs with BCG scars were greatly reduced compared to those without scars: (adjusted geometric mean ratio) IFNc 0.20 (0.09–0.42), ,0.0001; IL-2 0.34 (0.20–0.59), ,0.0001; and TNFa 0.36 (0.16–0.79), 0.01. Conclusions: We found no evidence that co-infections increase the risk of LTBI, or influence the cytokine response profile among those with LTBI. Prior BCG exposure may reduce Th1 cytokine responses in LTBI.en_US
dc.identifier.citationBiraro IA, Egesa M, Toulza F, Levin J, Cose S, et al. (2014) Impact of Co-Infections and BCG Immunisation on Immune Responses among Household Contacts of Tuberculosis Patients in a Ugandan Cohort. PLoS ONE 9(11): e111517. doi:10.1371/journal.pone.0111517en_US
dc.identifier.other10.1371/journal.pone.0111517
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/7044
dc.language.isoenen_US
dc.publisherPLoS ONEen_US
dc.subjectCo-Infectionsen_US
dc.subjectBCG Immunisationen_US
dc.subjectImmune Responsesen_US
dc.subjectHousehold Contactsen_US
dc.subjectTuberculosis Patientsen_US
dc.titleImpact of Co-Infections and BCG Immunisation on Immune Responses among Household Contacts of Tuberculosis Patients in a Ugandan Cohorten_US
dc.typeArticleen_US
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