THE IN-VITRO INDUCTION OF HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) REPLICATION IN PURIFIED PROTEIN DERIVATIVE-POSITIVE HIV-INFECTED PERSONS BY RECALL ANTIGEN RESPONSE TO MYCOBACTERIUM-TUBERCULOSIS IS THE RESULT OF ABALANCE OF THE EFFECTS OF ENDOGENOUS INTERLEUKIN-2 AND PROINFLAMMATORY AND ANTIINFLAMMATORY CYTOKINES

Coinfection with Mycobacterium tuberculosis and human immunodeficiency virus (HIV) is a serious problem, particularly in developing countrie s. Recently, M. tuberculosis and purified protein derivative (PPD) wer e demonstrated to induce HIV replication in CD8 T cell-depleted periph eral blood mononuclear cells from HIV-positive, PPD-positive persons b ut not in cells from PPD-negative persons. The role of endogenous and exogenous cytokines in modulating M. tuberculosis-induced HIV replicat ion was evaluated. M. tuberculosis-induced HIV replication decreased f ollowing simultaneous inhibition of endogenous interleukin (IL)-2, IL- 1 beta, and tumor necrosis factor-alpha by the addition of soluble rec eptors and receptor antagonists or following exogenous IL-10 and trans forming growth factor (TGF)-beta. In contrast, neutralization of endog enous IL-10 and TGF-beta augmented M. tuberculosis-induced HIV replica tion by increasing cellular activation. Thus, the balance between IL-2 and proinflammatory and antiinflammatory cytokines plays a major role in,II. tuberculosis-induced replication of HIV.