CLINICAL CORRELATES OF INTERFERON-GAMMA PRODUCTION IN PATIENTS WITH TUBERCULOSIS

To determine if the capacity to produce interferon (IFN) gamma is rela ted to the clinical manifestations of tuberculosis, we correlated Myco bacterium tuberculosis-induced IFN-gamma production by peripheral bloo d mononuclear cells (PBMCs) with clinical, radiographic, and laborator y variables for 63 human immunodeficiency virus (HIV)-negative patient s and 43 HIV-positive patients with tuberculosis, For HIV-negative pat ients whose chest radiographs showed moderately advanced disease, the mean IFN-gamma concentration +/- SD was 1,639 +/- 388 pg/mL, whereas t hat for patients with far-advanced disease was 327 +/- 100 pg/mL (P =. 0001), For HIV-infected patients who had only pleuropulmonary disease, the mean IFN-gamma concentration was 1,002 +/- 257 pg/mL, whereas tha t for patients with disease outside the lungs and pleura was 149 +/- 5 5 pg/mL (P =.0004). Multivariate analysis confirmed that the radiograp hic extent of disease and the site of disease were the only independen t predictors of IFN-gamma production in HIV-negative and HIV-infected patients (P less than or equal to .001). We conclude that reduced IFN- gamma production by PBMCs is a marker of severe tuberculosis in both H IV-negative and HIV-infected patients with tuberculosis.