The Mtb-HIV syndemic interaction: why treating M. tuberculosis infection may be crucial for HIV-1 eradication
- PMID: 32273900
- PMCID: PMC7132588
- DOI: 10.2217/fvl-2019-0069
The Mtb-HIV syndemic interaction: why treating M. tuberculosis infection may be crucial for HIV-1 eradication
Abstract
Accelerated tuberculosis and AIDS progression seen in HIV-1 and Mycobacterium tuberculosis (Mtb)-coinfected individuals indicates the important interaction between these syndemic pathogens. The immunological interaction between HIV-1 and Mtb has been largely defined by how the virus exacerbates tuberculosis disease pathogenesis. Understanding of the mechanisms by which pre-existing or subsequent Mtb infection may favor the replication, persistence and progression of HIV, is less characterized. We present a rationale for the critical consideration of 'latent' Mtb infection in HIV-1 prevention and cure strategies. In support of this position, we review evidence of the effect of Mtb infection on HIV-1 acquisition, replication and persistence. We propose that 'latent' Mtb infection may have considerable impact on HIV-1 pathogenesis and the continuing HIV-1 epidemic in sub-Saharan Africa.
Keywords: AIDS; HIV-1 cure; granuloma; immune activation; latency; transmission; tuberculosis; viral expansion; viral reservoir.
© 2020 Anna Coussens.
Conflict of interest statement
Financial & competing interests disclosure R Waters is supported by the Dept Orthopaedic Surgery (UCT) PhD Scholarship; M Ndengane is supported by the South African National Research Foundation (NRF) PhD Scholarship; CR Diedrich is supported by NIH AI 134195; MR Abrahams is supported by the South African Department of Higher Education and Training’s New Generation of Academics Programme; RJ Wilkinson is supported by the Francis Crick Institute, which receives funding from the Cancer Research (UK) (10218), and Wellcome (10218) UKRI (10218) and by Wellcome (104803, 203135); AK Coussens is supported by the Walter and Eliza Hall Institute of Medical Research, the Medical Research Council of South Africa (SHIP-02-2013), the National Institute of Health TB Research Unit (U19AI111276) and the NRF (UID109040). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.
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