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Diminished Mycobacterium tuberculosis–specific T-cell Responses During Pregnancy in Women With HIV and Receiving Isoniazid Preventive Therapy

Title: Diminished Mycobacterium tuberculosis–specific T-cell Responses During Pregnancy in Women With HIV and Receiving Isoniazid Preventive Therapy
Authors: Saha, Aparajita; Escudero, Jaclyn N; Layouni, Troy; Mecha, Jerphason; Maleche-Obimbo, Elizabeth; Matemo, Daniel; Kinuthia, John; John-Stewart, Grace; Richardson, Barbra A; LaCourse, Sylvia M; Shah, Javeed A
Contributors: Eunice Kennedy Shriver National Institute of Child Health and Human Development; National Institute of Allergy and Infectious Diseases; NIH
Source: Open Forum Infectious Diseases ; volume 12, issue 2 ; ISSN 2328-8957
Publisher Information: Oxford University Press (OUP)
Publication Year: 2025
Description: Background Pregnancy increases Mycobacterium tuberculosis (Mtb) reactivation risk and alters immune responses. We assessed Mtb-specific CD4+ T-cell responses in pregnant women with HIV (WLHIV) and without, including those receiving isoniazid preventive therapy (IPT). Methods We measured adaptive immune responses from 33 participants (HIV+ 21, HIV− 12) with positive interferon-gamma release assay during pregnancy (20–34 weeks’ gestation), 6 weeks, and 12 months postpartum by intracellular cytokine staining. We measured overall responses using COMPASS and made comparisons by nonparametric analysis of variance. Result We observed diminished Mtb-specific CD4+ T-cell responses in WLHIV during pregnancy versus 12 months postpartum (COMPASS median functional score [FS] .009 vs 0.12, P = .03). WLHIV who received IPT (n = 8) during concurrent pregnancy had attenuated Mtb-specific CD4+ T-cell responses during pregnancy versus 12 months postpartum (median FS 8.3 × 10−7 vs 0.13, P = .02), but WLHIV who did not receive IPT during pregnancy had similar responses in pregnancy and postpartum. Mtb-specific CD8+ FS was increased postpartum in all groups. We found preexisting Mtb-specific CD4+ T-cell responses in participants who converted interferon-gamma release assay tests postpartum (n = 10). Conclusions Pregnant WLHIV, especially those on IPT, showed reduced Mtb-specific CD4+ T-cell responses. Understanding the impact of pregnancy on Mtb-specific T-cell responses may improve diagnostic approaches.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/ofid/ofaf067
DOI: 10.1093/ofid/ofaf067/61770419/ofaf067.pdf
Availability: https://doi.org/10.1093/ofid/ofaf067; https://academic.oup.com/ofid/advance-article-pdf/doi/10.1093/ofid/ofaf067/61770419/ofaf067.pdf; https://academic.oup.com/ofid/article-pdf/12/2/ofaf067/61770419/ofaf067.pdf
Rights: https://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.D4FDCAC1
Database: BASE