Effects of Tuberculosis on the Kinetics of CD4+ T Cell Count Among HIV-Infected Patients Who Initiated Antiretroviral Therapy Early After Tuberculosis Treatment

The effects of tuberculosis (TB) on the kinetics of CD4(+) T cells among HIV-infected individuals with early combination antiretroviral therapy (cART) after TB therapy initiation are poorly characterized. We conducted a case-control study with 15 HIV-TB-coinfected patients who initiated TB treatment and early cART, and 30 controls without TB who had similar CD4(+) T cell counts and viral loads at the time of starting cART. We compared the rate of CD4(+) T cell increase for 5 years after cART. The time to CD4(+) T cell increase > 250 cells/mm(3) was significantly slower in HIV-TB-coinfected patients (p = 0.015, by log rank test). HIV-TB-coinfected patients had significantly lower median CD4(+) T cell counts at 5 years after cART (p = 0.048). The difference in CD4(+) T cell increase was observed only during the first 6 months after cART initiation (p = 0.002). These data suggest that TB slows the rate of CD4(+) T cell recovery at an early period after cART. The effects of TB on the long-term immunity of HIV-infected patients should be further evaluated.