Pleural Tuberculosis in Patients with Early HIV Infection Is Associated with Increased TNF-Alpha Expression and Necrosis in Granulomas |
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| Authors: | Juanita Bezuidenhout Teri Roberts Liesel Muller Paul van Helden Gerhard Walzl |
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| Institution: | 1. Department of Histopathology, Tygerberg Hospital, Cape Town, Western Cape, South Africa.; 2. Molecular Biology and Human Genetics, MRC Centre for Molecular and Cellular Biology, DST/NRF Centre of Excellence for Biomedical TB Research, Department of Biomedical Sciences, Faculty of Health Sciences, University of Stellenbosch, Cape Town, Western Cape, South Africa.;University of Stellenbosch, South Africa |
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| Abstract: | Although granulomas may be an essential host response against persistent antigens, they are also associated with immunopathology. We investigated whether HIV co-infection affects histopathological appearance and cytokine profiles of pleural granulomas in patients with active pleural tuberculosis (TB). Granulomas were investigated in pleural biopsies from HIV positive and negative TB pleuritis patients. Granulomas were characterised as necrotic or non-necrotic, graded histologically and investigated for the mRNA expression of IL-12, IFN-γ, TNF-α and IL-4 by in situ hybridisation. In all TB patients a mixed Th1/Th2 profile was noted. Necrotic granulomas were more evident in HIV positive patients with a clear association between TNF-α and necrosis. This study demonstrates immune dysregulation which may include TNF-α-mediated immunopathology at the site of disease in HIV infected pleural TB patients. |
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