Tuberculosis, the world’s leading infectious disease killer, is also the leading cause of death in infants with HIV. Researchers at Tulane National Primate Research Center will use a new $6.1 million grant from the National Institutes of Health to better understand how the developing immune system responds to the two diseases so that doctors can improve outcomes for infants and children across the globe.
According to UNAIDS, 1.8 million children are currently living with HIV/AIDS. HIV is usually transmitted to infants at birth, and the untreated disease leaves their immune systems particularly vulnerable to an infection as devastating as tuberculosis. This is of particular concern in low-resource countries, where the lack of treatment for HIV greatly accelerates the progress and spread of tuberculosis.
While the progression of tuberculosis in HIV-infected adults has been previously studied, the unique immune response in infants is currently unknown.
“Our previous studies in nonhuman primates have provided us tremendous insight into understanding how HIV develops,” says lead investigator Xiaolei Wang, assistant professor of pathology and laboratory medicine. “We have learned that HIV tends to uniquely ‘compartmentalize’ in infants by developing in specific organs. This provides an opportunity for us to develop targeted treatments that may slow or even halt the progression of the disease.”
Using a nonhuman primate model of HIV infection, Wang plans to study immune response to tuberculosis upon receiving combination antiretroviral therapy. Combination antiretroviral therapy (cART) is the current gold standard for controlling HIV by interfering with the virus’s replication process. This suppresses the disease enough that an individual’s immune system can continue to fight off other infections. Recent studies initiating early antiretroviral therapy in HIV-infected infants have been promising and suggest that specific treatments that include cART may be able to interfere with the spread of tuberculosis.
“Our hope is that by understanding how certain therapies boost immune function, we will be able to control the development of tuberculosis. This could have a profound effect on improving the health of infants and children that are co-infected with HIV and tuberculosis worldwide.”
According to the World Health Organization, there were 10.4 million cases of tuberculosis worldwide in 2015, including 1.2 million cases among people living with HIV. Nearly 60% of those co-infected with both HIV and tuberculosis were untreated, resulting in 390,000 deaths.