Despite being treated with antiretroviral drugs, some HIV patients become ill because the recovering immune system produces an overwhelming response to infections that the HIV infection has caused.
In an article to be published on World AIDS Day (December 1), researchers at The University of Western Australia in collaboration with investigators in Phnom Penh, Cambodia and at the University of New South Wales investigate the causes of what is known as ‘immune restoration disease’.
Lead author Ben Oliver is a PhD student in UWA’s School of Pathology and Laboratory Medicine. Research project leader, Winthrop Professor Martyn French, said tuberculosis was the most common opportunistic infection associated with HIV infection and the leading cause of disease and death in people living with HIV/AIDS in resource-poor countries.
“The World Health Organisation estimates that there are about 11 million people in the world who are infected by HIV and Mycobacterium tuberculosis (the bacterium that causes tuberculosis). In 2009, 1.1 million new cases of TB and HIV infection were diagnosed,” Professor French said. Treatment of HIV patients with antiretroviral drugs improves immunity to tuberculosis.
“However, immune restoration disease affects up to 40 per cent of patients with both HIV infection and TB after they commence antiretroviral therapy and is therefore a major problem in countries where HIV infection and TB are common.”
The UWA researchers have identified two different disease pathways that can cause immune restoration disease in patients with HIV and tuberculosis.
Professor French said the work was of particular importance because of the high prevalence of tuberculosis in south-east Asia and sub-Saharan Africa. “As antiretroviral therapy becomes more readily available for the treatment of HIV infection, tuberculosis related immune restoration disease is expected to rise sharply”, he said.
Professor French said that the findings of the research study will open up opportunities for new diagnostic and treatment strategies which could lead to a reduction in illness and death in these regions of the world.
The article will be published in the Journal of Infectious Diseases.
This work will be presented at the Australian Society for Immunology Conference to be held at the Perth Exhibition and Convention Centre on 5 – 9 December 2010.