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HIV infection disrupts the sympatric host-pathogen relationship in human tuberculosis

Fenner, Lukas and Egger, Matthias and Bodmer, Thomas and Furrer, Hansjakob and Ballif, Marie and Battegay, Manuel and Helbling, Peter and Fehr, Jan and Gsponer, Thomas and Rieder, Hans L. and Zwahlen, Marcel and Hoffmann, Matthias and Bernasconi, Enos and Cavassini, Matthias and Calmy, Alexandra and Dolina, Marisa and Frei, Reno and Janssens, Jean-Paul and Borrell, Sonia and Stucki, David and Schrenzel, Jacques and Böttger, Erik C. and Gagneux, Sebastien and Swiss HIV Cohort, and Molecular Epidemiology of Tuberculosis Study Groups, . (2013) HIV infection disrupts the sympatric host-pathogen relationship in human tuberculosis. PLoS genetics, Vol. 9, H. 3 , e1003318.

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Official URL: http://edoc.unibas.ch/dok/A6124541

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Abstract

The phylogeographic population structure of Mycobacterium tuberculosis suggests local adaptation to sympatric human populations. We hypothesized that HIV infection, which induces immunodeficiency, will alter the sympatric relationship between M. tuberculosis and its human host. To test this hypothesis, we performed a nine-year nation-wide molecular-epidemiological study of HIV-infected and HIV-negative patients with tuberculosis (TB) between 2000 and 2008 in Switzerland. We analyzed 518 TB patients of whom 112 (21.6%) were HIV-infected and 233 (45.0%) were born in Europe. We found that among European-born TB patients, recent transmission was more likely to occur in sympatric compared to allopatric host-pathogen combinations (adjusted odds ratio [OR] 7.5, 95% confidence interval [95% CI] 1.21-infinity, p = 0.03). HIV infection was significantly associated with TB caused by an allopatric (as opposed to sympatric) M. tuberculosis lineage (OR 7.0, 95% CI 2.5-19.1, p>0.0001). This association remained when adjusting for frequent travelling, contact with foreigners, age, sex, and country of birth (adjusted OR 5.6, 95% CI 1.5-20.8, p = 0.01). Moreover, it became stronger with greater immunosuppression as defined by CD4 T-cell depletion and was not the result of increased social mixing in HIV-infected patients. Our observation was replicated in a second independent panel of 440 M. tuberculosis strains collected during a population-based study in the Canton of Bern between 1991 and 2011. In summary, these findings support a model for TB in which the stable relationship between the human host and its locally adapted M. tuberculosis is disrupted by HIV infection.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medical Parasitology and Infection Biology > Tuberculosis Research (Gagneux)
UniBasel Contributors:Ballif, Marie and Borrell, Sonia and Gagneux, Sebastien
Item Type:Article, refereed
Bibsysno:Link to catalogue
Publisher:Public Library of Science
ISSN:1553-7390
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:16 Aug 2013 07:34
Deposited On:16 Aug 2013 07:30

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