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Risk factors for increased immune reconstitution in response to Mycobacterium tuberculosis antigens in tuberculosis HIV-infected, antiretroviral-naïve patients

Overview of attention for article published in BMC Infectious Diseases, September 2017
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4 tweeters

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5 Dimensions

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70 Mendeley
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Title
Risk factors for increased immune reconstitution in response to Mycobacterium tuberculosis antigens in tuberculosis HIV-infected, antiretroviral-naïve patients
Published in
BMC Infectious Diseases, September 2017
DOI 10.1186/s12879-017-2700-6
Pubmed ID
Authors

Tatiana Pereira da Silva, Carmem Beatriz Wagner Giacoia-Gripp, Carolina A. Schmaltz, Flavia Marinho Sant’Anna, Maria Helena Saad, Juliana Arruda de Matos, Julio Castro Alves de Lima e Silva, Valeria Cavalcanti Rolla, Mariza Gonçalves Morgado

Abstract

Little is known regarding the restoration of the specific immune response after combined antiretroviral therapy (cART) and anti-tuberculosis (TB) therapy introduction among TB-HIV patients. In this study, we examined the immune response of TB-HIV patients to Mycobacterium tuberculosis (Mtb) antigens to evaluate the response dynamics to different antigens over time. Moreover, we also evaluated the influence of two different doses of efavirenz and the factors associated with immune reconstitution. This is a longitudinal study nested in a clinical trial, where cART was initiated during the baseline visit (D0), which occurred 30 ± 10 days after the introduction of anti-TB therapy. Follow-up visits were performed at 30, 60, 90 and 180 days after cART initiation. The production of IFN-γ upon in vitro stimulation with Mtb antigens purified protein derivative (PPD), ESAT-6 and 38 kDa/CFP-10 using ELISpot was examined at baseline and follow-up visits. Sixty-one patients, all ART-naïve, were selected and included in the immune reconstitution analysis; seven (11.5%) developed Immune Reconstitution Inflammatory Syndrome (IRIS). The Mtb specific immune response was higher for the PPD antigen followed by 38 kDa/CFP-10 and increased in the first 60 days after cART initiation. In multivariate analysis, the variables independently associated with increased IFN-γ production in response to PPD antigen were CD4(+) T cell counts <200 cells/mm(3) at baseline, age, site of tuberculosis, 800 mg efavirenz dose and follow-up CD4(+) T cell counts. Moreover, the factors associated with the production of IFN-γ in response to 38 kDa/CFP-10 were detectable HIV viral load (VL) and CD4(+) T cell counts at follow-up visits of ≥200 cells/mm(3). These findings highlight the differences in immune response according to the specificity of the Mtb antigen, which contributes to a better understanding of TB-HIV immunopathogenesis. IFN-γ production elicited by PPD and 38 kDa/CFP-10 antigens have a greater magnitude compared to ESAT-6 and are associated with different factors. The low response to ESAT-6, even during immune restoration, suggests that this antigen is not adequate to assess the immune response of immunosuppressed TB-HIV patients.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 70 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 70 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 11 16%
Researcher 8 11%
Student > Bachelor 8 11%
Student > Doctoral Student 7 10%
Student > Postgraduate 6 9%
Other 14 20%
Unknown 16 23%
Readers by discipline Count As %
Medicine and Dentistry 25 36%
Immunology and Microbiology 9 13%
Biochemistry, Genetics and Molecular Biology 4 6%
Agricultural and Biological Sciences 3 4%
Nursing and Health Professions 3 4%
Other 7 10%
Unknown 19 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 October 2017.
All research outputs
#10,140,789
of 15,916,110 outputs
Outputs from BMC Infectious Diseases
#3,196
of 5,796 outputs
Outputs of similar age
#161,018
of 274,861 outputs
Outputs of similar age from BMC Infectious Diseases
#1
of 2 outputs
Altmetric has tracked 15,916,110 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,796 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.8. This one is in the 36th percentile – i.e., 36% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 274,861 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 2 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them