Active TB in HIV-1-infected subjects is associated with increased HIV-1-rel
ated immunodeficiency and mortality. We assessed plasma viral load in HIV-1
-infected patients with pulmonary TB (HIV/TB) and non-TB symptomatic HIV-1-
infected patients (HIV). HIV-1 load was higher in HIV/TB compared with HIV
at higher CD4 counts (> 500/mul) (P < 0.01), but not at lower CD4 counts (<
500/mul). We also evaluated the status of HIV-1 gene expression in periphe
ral blood mononuclear cells (PBMC) and serum from HIV/TB and CD4-matched he
althy HIV-infected patients (HIV/C) by reverse transcriptase-polymerase cha
in reaction over a range of CD4 (> 900/mul to < 200/mul). HIV-1 RNA in seru
m and PBMC correlated to one another, and both were markedly higher in HIV/
TB compared with HIV/C with higher CD4 counts. Also, during a longitudinal
study of anti-tuberculous chemoprophylaxis in HIV-1-infected patients, 10 s
ubjects who developed TB had serologies before, at the time, and after the
diagnosis of TB. These HIV/TB patients had an increase in viral load (avera
ge 2.5-fold) at the time of diagnosis of TB (P < 0.05). Overall, these data
indicate that the transcriptional activity of HIV-1 is enhanced in HIV-1-i
nfected patients with active TB, especially during early HIV-1 disease. As
TB often is an early HIV-1 opportunistic infection, it may particularly fav
our early viral replication and dissemination, and therefore contribute to
progression of HIV-1 disease.