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Nakanjako D, Nabatanzi R, Ssinabulya I, Bayigga L, Kiragga A, Banturaki G, Castelnuovo B. Chronic immune activation and accelerated immune aging among HIV-infected adults receiving suppressive antiretroviral therapy for at least 12 years in an African cohort. Heliyon 2024; 10:e31910. [PMID: 38882354 PMCID: PMC11177148 DOI: 10.1016/j.heliyon.2024.e31910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/23/2024] [Accepted: 05/23/2024] [Indexed: 06/18/2024] Open
Abstract
Background HIV-associated alterations innate and adaptive immune cell compartments are reminiscent of the process of immune aging. Objectives We described immune aging phenotypes among ART-treated HIV-infected adults relative to age-matched HIV-negative counterparts. Methods In a cross-sectional comparative study of HIV-infected adults with CD4≥500 cells/μl after at least 12 years of suppressive ART and age-and-gender-matched HIV-negative individuals, immune activation and immune aging phenotypes were measured, using multi-color flowcytometry. Results ART-treated HIV-infected individuals had higher body mass index (P = 0.004), waist-hip circumference (P = 0.041), hip circumference (P < 0.001), and diastolic blood pressure (P = 0.012) and immune activation (CD4+CD38+HLADR+; median 4.15,IQR(1.030,14.6)] relative to the HIV-negative age-matched individuals [median 3.14,IQR(1.030, 6.68)]; P=0.0034. Immune aging markers [CD4+CD57+T-cells; median 13.00 IQR (0.45,64.1)] were higher among HIV-infected ART-treated adults<50 years relative to HIV-negative<50 years[median 8.020,IQR(0.004,21.2)]; P=0.0010. Naïve CD4 T-cells, Central memory CD4 T-cells, Terminal Effector Memory T cells (TEMRA: CD27-CD45RA + CCR7-) and immune senescence CD4/CD8+CD28-/CD57+ T-cells were similar among ART-treated HIV-infected individuals<45 years relative to 60 years-and-older HIV-negative counterparts≥; p = 0.0932, p = 0.05357, p = 0.0950 and p = 0.5714 respectively. Conclusion ART-treated adults are immunologically two decades older than their HIV-negative counterparts. Accelerated immune aging among individuals aging with HIV underscores the need for an HIV cure to avert the unprecedented complications of accelerated immune senescence and the associated NCD risk in African settings with protracted exposure to endemic co-infections.
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Affiliation(s)
- Damalie Nakanjako
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Rose Nabatanzi
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Isaac Ssinabulya
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Uganda Heart Institute, Kampala, Uganda
| | - Lois Bayigga
- Department of Immunology and Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Agnes Kiragga
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Grace Banturaki
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Barbara Castelnuovo
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
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Pean P, Madec Y, Nerrienet E, Borand L, Laureillard D, Fernandez M, Marcy O, Scott-Algara D. Natural Killer Repertoire Restoration in TB/HIV Co-Infected Individuals Experienced an Immune Reconstitution Syndrome (CAMELIA Trial, ANRS 12153). Pathogens 2023; 12:1241. [PMID: 37887757 PMCID: PMC10610037 DOI: 10.3390/pathogens12101241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
IRIS is a common complication in HIV-infected patients treated for tuberculosis (TB) and cART. Our aim was to evaluate NK cell reconstitution in HIV-infected patients with TB-IRIS compared to those without IRIS. 147 HIV-infected patients with TB from the CAMELIA trial were enrolled. HIV+TB+ patients were followed for 32 weeks. The NK cell repertoire was assessed in whole blood at different time points. As CAMELIA has two arms (early and late cART initiation), we analysed them separately. At enrolment, individuals had low CD4 cell counts (27 cells/mm3) and high plasma viral loads (5.76 and 5.50 log/mL for IRIS and non-IRIS individuals, respectively). Thirty-seven people developed IRIS (in the early and late arms). In the early and late arms, we observed similar proportions of total NK and NK cell subsets in TB-IRIS and non-IRIS individuals during follow-up, except for the CD56dimCD16pos (both arms) and CD56dimCD16neg (late arm only) subsets, which were higher in TB-IRIS and non-IRIS individuals, respectively, after cART. Regarding the repertoire and markers of NK cells, significant differences (lower expression of NKp30, NKG2A (CD159a), NKG2D (CD314) were observed in TB-IRIS compared to non-IRIS individuals after the start of cART. In the late arm, some changes (increased expression of CD69, NKG2C, CD158i) were observed in TB-IRIS compared to non-IRIS individuals, but only before cART initiation (during TB treatment). KIR expression by NK cells (CD158a and CD158i) was similar in both groups. CD69 expression by NK cells decreased in all groups. Expression of the NCR repertoire (NKp30, NKp44, NKp46) has similar kinetics in TB-IRIS subjects compared to non-IRIS subjects regardless of the arm analysed. NK cell reconstitution appeared to be better in TB-IRIS subjects. Although NK cell reconstitution is impaired in HIV infection after cART, as previously reported, it does not appear to be affected by the development of IRIS in HIV and TB-infected individuals.
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Affiliation(s)
- Polidy Pean
- Immunology Unit, Institute Pasteur du Cambodge, Phnom Pen 12000, Cambodia
| | - Yoann Madec
- Epidemiology of Emerging Diseases, Institut Pasteur, Université de Paris, 75000 Paris, France;
| | | | - Laurence Borand
- Clinical Research Team, Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phom Penh 12000, Cambodia;
- Center for Tuberculosis Research, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 20600, USA
| | - Didier Laureillard
- Infectious and Tropical Diseases Department, University Hospital, 30900 Nimes, France;
| | | | - Olivier Marcy
- Research Institute for Sustainable Development (IRD) EMR 271, National Institute for Health and Medical Research (INSERM) UMR 1219, University of Bordeaux, 33000 Bordeaux, France;
| | - Daniel Scott-Algara
- Unité de Biologie Cellulaire et Lymphocytes, Institut Pasteur, 75000 Paris, France;
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Cocker ATH, Guethlein LA, Parham P. The CD56-CD16+ NK cell subset in chronic infections. Biochem Soc Trans 2023:233017. [PMID: 37140380 DOI: 10.1042/bst20221374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 05/05/2023]
Abstract
Long-term human diseases can shape the immune system, and natural killer (NK) cells have been documented to differentiate into distinct subsets specifically associated with chronic virus infections. One of these subsets found in large frequencies in HIV-1 are the CD56-CD16+ NK cells, and this population's association with chronic virus infections is the subject of this review. Human NK cells are classically defined by CD56 expression, yet increasing evidence supports the NK cell status of the CD56-CD16+ subset which we discuss herein. We then discuss the evidence linking CD56-CD16+ NK cells to chronic virus infections, and the potential immunological pathways that are altered by long-term infection that could be inducing the population's differentiation. An important aspect of NK cell regulation is their interaction with human leukocyte antigen (HLA) class-I molecules, and we highlight work that indicates both virus and genetic-mediated variations in HLA expression that have been linked to CD56-CD16+ NK cell frequencies. Finally, we offer a perspective on CD56-CD16+ NK cell function, taking into account recent work that implies the subset is comparable to CD56+CD16+ NK cell functionality in antibody-dependent cell cytotoxicity response, and the definition of CD56-CD16+ NK cell subpopulations with varying degranulation capacity against target cells.
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Affiliation(s)
- Alexander T H Cocker
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, U.S.A
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, U.S.A
| | - Lisbeth A Guethlein
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, U.S.A
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, U.S.A
| | - Peter Parham
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, U.S.A
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, U.S.A
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Ko Y, Wee YM, Shin S, Kim MJ, Choi MY, Kim DH, Lim SJ, Jung JH, Kwon H, Kim YH, Han DJ. A prospective, randomized, non-blinded, non-inferiority pilot study to assess the effect of low-dose anti-thymocyte globulin with low-dose tacrolimus and early steroid withdrawal on clinical outcomes in non-sensitized living-donor kidney recipients. PLoS One 2023; 18:e0280924. [PMID: 36857393 PMCID: PMC9976999 DOI: 10.1371/journal.pone.0280924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/21/2022] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND The optimal dose of anti-thymocyte globulin (ATG) as an induction regimen in Asian living-donor kidney recipients is unclear. METHODS This is a pilot study in which 36 consecutive patients undergoing living-donor kidney transplantation were randomly assigned to receive either 4.5 mg/kg (n = 19) or 6.0 mg/kg (n = 17) of ATG; all patients had corticosteroid withdrawal within 7 days. The primary end point was a composite of biopsy-proven acute rejection, de novo donor-specific antibody formation, and graft failure. RESULTS At 12 months post-transplant, biopsy-proven acute rejection was more common in the ATG4.5 group (21.1%) than in the ATG6.0 group (0%)(P = .048). Importantly, the rate of the composite end point was significantly higher in the ATG4.5 group (36.8% vs 0%)(P = .006). There were significant differences in neither the renal function nor adverse events between the two groups. One case of death-censored graft failure occurred in the ATG4.5 group and no mortality was observed overall. Compared with pre-transplantation, T cells, natural killer (NK) cells, and natural killer T (NKT) cells were significantly decreased in the first week post-transplantation except for B cells. Although T and NKT cells in both groups and NK cells in the ATG4.5 group had recovered to the pre-transplant levels, NK cells in the ATG6.0 group remained suppressed until six months post-transplant. CONCLUSIONS Compared with ATG 6.0 mg/kg, ATG 4.5 mg/kg with early corticosteroid withdrawal and low dose maintenance regimen was associated with higher rates of acute rejection in non-sensitized Asian living-donor kidney recipients. TRIAL REGISTRATION ClinicalTrials.gov: NCT02447822.
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Affiliation(s)
- Youngmin Ko
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yu-Mee Wee
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Shin
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- * E-mail:
| | - Mi Joung Kim
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Monica Young Choi
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Hyun Kim
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong Jun Lim
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joo Hee Jung
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyunwook Kwon
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hoon Kim
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Duck Jong Han
- Department of Surgery, Division of Kidney and Pancreas Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Yan L, Xu K, Xiao Q, Tuo L, Luo T, Wang S, Yang R, Zhang F, Yang X. Cellular and molecular insights into incomplete immune recovery in HIV/AIDS patients. Front Immunol 2023; 14:1152951. [PMID: 37205108 PMCID: PMC10185893 DOI: 10.3389/fimmu.2023.1152951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/18/2023] [Indexed: 05/21/2023] Open
Abstract
Highly active antiretroviral therapy (ART) can effectively inhibit virus replication and restore immune function in most people living with human immunodeficiency virus (HIV). However, an important proportion of patients fail to achieve a satisfactory increase in CD4+ T cell counts. This state is called incomplete immune reconstitution or immunological nonresponse (INR). Patients with INR have an increased risk of clinical progression and higher rates of mortality. Despite widespread attention to INR, the precise mechanisms remain unclear. In this review, we will discuss the alterations in the quantity and quality of CD4+ T as well as multiple immunocytes, changes in soluble molecules and cytokines, and their relationship with INR, aimed to provide cellular and molecular insights into incomplete immune reconstitution.
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Affiliation(s)
- Liting Yan
- Department of Infectious Disease, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
- *Correspondence: Xingxiang Yang, ; Fujie Zhang, ; Liting Yan,
| | - Kaiju Xu
- Department of Infectious Disease, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Qing Xiao
- Clinical and Research Center for Infectious Diseases, Beijing Ditan Hospital, Beijing, China
| | - Lin Tuo
- Department of Infectious Disease, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Tingting Luo
- Department of Infectious Disease, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Shuqiang Wang
- Department of Infectious Disease, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Renguo Yang
- Department of Infectious Disease, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Fujie Zhang
- Clinical and Research Center for Infectious Diseases, Beijing Ditan Hospital, Beijing, China
- *Correspondence: Xingxiang Yang, ; Fujie Zhang, ; Liting Yan,
| | - Xingxiang Yang
- Department of Infectious Disease, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
- *Correspondence: Xingxiang Yang, ; Fujie Zhang, ; Liting Yan,
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Cocker ATH, Liu F, Djaoud Z, Guethlein LA, Parham P. CD56-negative NK cells: Frequency in peripheral blood, expansion during HIV-1 infection, functional capacity, and KIR expression. Front Immunol 2022; 13:992723. [PMID: 36211403 PMCID: PMC9539804 DOI: 10.3389/fimmu.2022.992723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Human NK cells are usually defined as CD3-CD56+ lymphocytes. However, a CD56-CD16+ (CD56neg) lymphocyte population that displays NK-associated markers expands during chronic viral infections such as HIV-1 and HCV, and, to lesser extent, in herpesvirus infections. This CD56neg NK cell subset has been understudied because it requires the exclusion of other lymphocytes to accurately identify its presence. Many questions remain regarding the origin, development, phenotype, and function of the CD56neg NK cell population. Our objective was to determine the frequency of this NK subset in healthy controls and its alteration in viral infections by performing a meta-analysis. In addition to this, we analyzed deposited CyTOF and scRNAseq datasets to define the phenotype and subsets of the CD56neg NK cell population, as well as their functional variation. We found in 757 individuals, from a combined 28 studies and 6 datasets, that the CD56neg subset constitutes 5.67% of NK cells in healthy peripheral blood, while HIV-1 infection increases this population by a mean difference of 10.69%. Meta-analysis of surface marker expression between NK subsets showed no evidence of increased exhaustion or decreased proliferation within the CD56neg subset. CD56neg NK cells have a distinctive pattern of KIR expression, implying they have a unique potential for KIR-mediated education. A perforin-CD94-NKG2C-NKp30- CD56neg population exhibited different gene expression and degranulation responses against K562 cells compared to other CD56neg cells. This analysis distinguishes two functionally distinct subsets of CD56neg NK cells. They are phenotypically diverse and have differing capacity for education by HLA class-I interactions with KIRs.
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Affiliation(s)
- Alexander T. H. Cocker
- Department of Structural Biology and Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
- *Correspondence: Alexander T. H. Cocker,
| | - Fuguo Liu
- Department of Structural Biology and Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
- Laboratory Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Zakia Djaoud
- Department of Structural Biology and Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Lisbeth A. Guethlein
- Department of Structural Biology and Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
| | - Peter Parham
- Department of Structural Biology and Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
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Qian F, Hu S, Zhu Y, Wang Y, Liu J, Qiao J, Shu X, Gao Y, Sun B, Zhu C. CD56dim NK Cell is an Important Factor in T Cell Depletion of cART-Treated AIDS Patients. Int J Gen Med 2022; 15:4575-4583. [PMID: 35535146 PMCID: PMC9078362 DOI: 10.2147/ijgm.s356771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/14/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate factors involved in T-cell depletion in combination antiretroviral therapy (cART)-treated human immunodeficiency virus 1 (HIV-1)-positive patients. Patients and Methods 29 HIV-1-positive patients were enrolled. The CD4+, CD8+ T cell subsets and CD56dim NK cells were detected by flow cytometry. The concentrations of cytokines were measured by enzyme-linked immunosorbent assay. Extraction, amplification, and viral load quantification of specimens were performed using the Roche Cobas Ampliprep/Cobas TaqMan HIV-1 test. Results Compared with IR group, the total number of red blood cells (RBCs) and lymphocytes (LCs) in INR group was significantly reduced, and there was a significant positive correlation between the number of RBCs and that of LCs. The overall production rates of T cells-related cytokines were lower in INR group. However, the cell-surface expression of programmed death-1 (PD-1) on CD4+ T and CD8+ T cells were markedly elevated in INR group. Moreover, it was found that the proportion and the killing ability of CD56dim NK cells significantly increased in INR patients, and significantly correlated with apoptosis of T lymphocytes. Conclusion A poor immune reconstitution in HIV-positive patients might result from multiple factors, including bone marrow suppression, high PD-1 expression on the surface of CD4+ T cells, and over-activation of T and NK cells. Besides, the activity of NK cells and RBCs count might be important auxiliary indicators for immune reconstitution and provided a reliable guidance for developing strategies to improve immune reconstitution.
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Affiliation(s)
- Feng Qian
- Department of Infectious Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, People’s Republic of China
- Department of Infectious Diseases, The Affiliated Infectious Disease Hospital of Soochow University, Suzhou, 215131, People’s Republic of China
- Department of Infectious Diseases, The Fifth People’s Hospital of Suzhou, Suzhou, 215131, People’s Republic of China
| | - Song Hu
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, 430056, People’s Republic of China
| | - Yueping Zhu
- Department of Infectious Diseases, The Affiliated Infectious Disease Hospital of Soochow University, Suzhou, 215131, People’s Republic of China
- Department of Infectious Diseases, The Fifth People’s Hospital of Suzhou, Suzhou, 215131, People’s Republic of China
| | - Yinling Wang
- Department of Infectious Diseases, The Affiliated Infectious Disease Hospital of Soochow University, Suzhou, 215131, People’s Republic of China
- Department of Infectious Diseases, The Fifth People’s Hospital of Suzhou, Suzhou, 215131, People’s Republic of China
| | - Jin Liu
- Department of Infectious Diseases, The Affiliated Infectious Disease Hospital of Soochow University, Suzhou, 215131, People’s Republic of China
- Department of Infectious Diseases, The Fifth People’s Hospital of Suzhou, Suzhou, 215131, People’s Republic of China
| | - Jialu Qiao
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, 430056, People’s Republic of China
| | - Xiji Shu
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, 430056, People’s Republic of China
| | - Yong Gao
- The First Affiliated Hospital, Department of Life Science and Medicine, University of Science and Technology of China, Hefei, 230001, People’s Republic of China
| | - Binlian Sun
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan, 430056, People’s Republic of China
| | - Chuanwu Zhu
- Department of Infectious Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, People’s Republic of China
- Department of Infectious Diseases, The Affiliated Infectious Disease Hospital of Soochow University, Suzhou, 215131, People’s Republic of China
- Department of Infectious Diseases, The Fifth People’s Hospital of Suzhou, Suzhou, 215131, People’s Republic of China
- Correspondence: Chuanwu Zhu; Binlian Sun, Tel/Fax +86 512 87806206; +86 27 84225149, Email ;
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Increased early activation of CD56dimCD16dim/- natural killer cells in immunological non-responders correlates with CD4+ T-cell recovery. Chin Med J (Engl) 2020; 133:2928-2939. [PMID: 33252378 PMCID: PMC7752673 DOI: 10.1097/cm9.0000000000001262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Natural killer (NK) cells play a critical role in suppressing human immunodeficiency virus-1 (HIV-1) infection, but knowledge on whether and how NK cells affect immune reconstitution in HIV-1-infected individuals who receive antiretroviral therapy (ART) is limited. METHODS We performed a case-control study with 35 healthy individuals and 66 HIV-1-infected patients including 32 immunological non-responders (INRs) with poor CD4+ T-cell recovery (<500 cells/μL after 4 years of ART) and 34 immunological responders (IRs) with improved CD4+ T-cell recovery (>500 cells/μL after 4 years of ART). NK cell phenotype, receptor repertoire, and early activation in INRs and IRs were investigated by flow cytometry. RESULTS A significantly higher proportion of CD56dimCD16dim/- NK cells was observed in INRs than IRs before ART and after 4 years of ART. The number of CD56dimCD16dim/- NK cells was inversely correlated with CD4+ T-cell counts in INRs before ART (r = -0.344, P = 0.050). The more CD69-expressing NK cells there were, the lower the CD4+ T-cell counts and ΔCD4, and these correlations were observed in INRs after ART (r = -0.416, P = 0.019; r = -0.509, P = 0.003, respectively). Additionally, CD69-expressing CD56dimCD16dim/- NK cells were more abundant in INRs than those in IRs (P = 0.018) after ART, both of which had an inverse association trend towards significance with CD4+ T-cell counts. The expression of the activating receptors NKG2C, NKG2D, and NKp46 on CD56dimCD16dim/- NK cell subsets were higher in IRs than that in INRs after 4 years of ART (all P < 0.01). Strong inverse correlations were observed between CD69 expression and NKG2C, NKG2A-NKG2C+, NKG2D, and NKp46 expression on CD56dimCD16dim/- NK cells in INRs after ART (NKG2C: r = -0.491, P = 0.004; NKG2A-NKG2C+: r = -0.434, P = 0.013; NKG2D: r = -0.405, P = 0.021; NKp46: r = -0.457, P = 0.008, respectively). CONCLUSIONS INRs had a larger number of CD56dimCD16dim/- NK cells characterized by higher activation levels than did IRs after ART. The increase in the CD56dimCD16dim/- NK cell subset may play an adverse role in immune reconstitution. Further functional studies of CD56dimCD16dim/- NK cells in INRs are urgently needed to inform targeted interventions to optimize immune recovery.
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Definition of Immunological Nonresponse to Antiretroviral Therapy: A Systematic Review. J Acquir Immune Defic Syndr 2020; 82:452-461. [PMID: 31592836 DOI: 10.1097/qai.0000000000002157] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Terms and criteria to classify people living with HIV on antiretroviral therapy who fail to achieve satisfactory CD4 T-cell counts are heterogeneous, and need revision and summarization. METHODS We performed a systematic review of PubMed original research articles containing a set of predefined terms, published in English between January 2009 and September 2018. The search retrieved initially 1360 studies, of which 103 were eligible. The representative terminology and criteria were extracted and analyzed. RESULTS Twenty-two terms and 73 criteria to define the condition were identified. The most frequent term was "immunological nonresponders" and the most frequent criterion was "CD4 T-cell count <350 cells/µL after ≥24 months of virologic suppression." Most criteria use CD4+ T-cell counts as a surrogate, either as an absolute value or as a change after a defined period of time [corrected]. Distinct values and time points were used. Only 9 of the 73 criteria were used by more than one independent research team. Herein we propose 2 criteria that could help to reach a consensus. CONCLUSIONS The high disparity in terms and criteria here reported precludes data aggregation and progression of the knowledge on this condition, because it renders impossible to compare data from different studies. This review will foster the discussion of terms and criteria to achieve a consensual definition.
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Nabatanzi R, Bayigga L, Cose S, Rowland-Jones S, Canderan G, Joloba M, Nakanjako D. Aberrant natural killer (NK) cell activation and dysfunction among ART-treated HIV-infected adults in an African cohort. Clin Immunol 2019; 201:55-60. [PMID: 30817998 PMCID: PMC6448528 DOI: 10.1016/j.clim.2019.02.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/07/2019] [Accepted: 02/23/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND We examined NK cell phenotypes and functions after seven years of ART and undetectable viral loads (<50 copies/ml) with restored CD4 T-cell counts (≥500 cells/μl) and age-matched healthy-HIV-uninfected individuals from the same community. METHODS Using flow-cytometry, NK cell phenotypes were described using lineage markers (CD56+/-CD16+/-). NK cell activation was determined by expression of activation receptors (NKG2D, NKp44 and NKp46) and activation marker CD69. NK cell function was determined by CD107a, granzyme-b, and IFN-gamma production. RESULTS CD56 dim and CD56 bright NK cells were lower among ART-treated-HIV-infected than among age-matched-HIV-negative individuals; p = 0.0016 and p = 0.05 respectively. Production of CD107a (P = 0.004) and Granzyme-B (P = 0.005) was lower among ART-treated-HIV-infected relative to the healthy-HIV-uninfected individuals. NKG2D and NKp46 were lower, while CD69 expression was higher among ART-treated-HIV-infected than healthy-HIV-uninfected individuals. CONCLUSION NK cell activation and dysfunction persisted despite seven years of suppressive ART with "normalization" of peripheral CD4 counts.
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Affiliation(s)
- Rose Nabatanzi
- Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Lois Bayigga
- Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Stephen Cose
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda; Department of Clinical Research, LSHTM, London, United Kingdom
| | - Sarah Rowland-Jones
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Moses Joloba
- Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Damalie Nakanjako
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda; Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.
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Nabatanzi R, Cose S, Joloba M, Jones SR, Nakanjako D. Effects of HIV infection and ART on phenotype and function of circulating monocytes, natural killer, and innate lymphoid cells. AIDS Res Ther 2018; 15:7. [PMID: 29544508 PMCID: PMC5853105 DOI: 10.1186/s12981-018-0194-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 03/09/2018] [Indexed: 12/11/2022] Open
Abstract
HIV infection causes upregulation of markers of inflammation, immune activation and apoptosis of host adaptive, and innate immune cells particularly monocytes, natural killer (NK) and innate lymphoid cells (ILCs). Although antiretroviral therapy (ART) restores CD4 T-cell counts, the persistent aberrant activation of monocytes, NK and ILCs observed likely contributes to the incomplete recovery of T-cell effector functions. A better understanding of the effects of HIV infection and ART on the phenotype and function of circulating monocytes, NK, and ILCs is required to guide development of novel therapeutic interventions to optimize immune recovery.
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Affiliation(s)
- Rose Nabatanzi
- Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, P. O. Box 7072, Kampala, Uganda.
| | - Stephen Cose
- MRC/UVRI Uganda Research Unit on AIDS and London School of Hygiene & Tropical Medicine, London, UK
| | - Moses Joloba
- Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, P. O. Box 7072, Kampala, Uganda
| | | | - Damalie Nakanjako
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
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12
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NK cells of HIV-1-infected patients with poor CD4 + T-cell reconstitution despite suppressive HAART show reduced IFN-γ production and high frequency of autoreactive CD56 bright cells. Immunol Lett 2017; 190:185-193. [PMID: 28826739 DOI: 10.1016/j.imlet.2017.08.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/07/2017] [Accepted: 08/11/2017] [Indexed: 11/21/2022]
Abstract
HIV-1-infected patients failing to recover CD4+ T-cell count despite HAART (immunological non-responders, NRs), are at increased risk of disease progression and death. To better understand the NR status, we performed a comprehensive assessment of NK cells in NR patients as compared to immunologic responders. NRs exhibited an accumulation of CD56bright NK cells inversely correlated with CD4+ counts. Both CD56bright and CD56dim NK cells of NRs displayed unimpaired degranulation ability, but poorly responded to cytokine stimulation in terms of NKp44 up-regulation and IFN-γ production that may explain the susceptibility of NRs to infections and tumors. Notably, CD56bright NK cells from NRs showed higher cytotoxicity against autologous activated CD4+ T cells. Moreover, NRs had reduced Treg cell counts that showed an inverse correlation with autoreactive CD56bright cells. These data suggest that accumulation of CD56bright NK cells, possibly linked to decreased homeostatic control by Tregs, contributes to poor immune reconstitution in NRs.
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13
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Sake CS, Ngu L, Ambada G, Chedjou JP, Nji N, Tchadji JC, Lissom A, Tchouangueu TF, Djukouo L, Njambe G, Garcia R, Gutierrez A, Bopda Waffo A, Park CG, Mbacham W, Etoa FX, Nchinda GW. The Effect of Antiretroviral Naïve HIV-1 Infection on the Ability of Natural Killer Cells to Produce IFN-γ upon Exposure to Plasmodium falciparum-Infected Erythrocytes. Biomed Hub 2017; 2:1-13. [PMID: 31988903 PMCID: PMC6945957 DOI: 10.1159/000467386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background In sub-Saharan Africa, intense perennial Plasmodium species transmission coincides with areas of high prevalence of the human immunodeficiency virus type 1 (HIV) infection. This implies that antiretroviral naïve HIV-infected people living within these regions are repeatedly exposed to Plasmodium species infection and consequently malaria. Natural killer (NK) cells are known to contribute to malaria immunity through the production of IFN-γ after exposure to Plasmodium falciparum-infected erythrocytes (infected red blood cells [iRBC]). However, in antiretroviral naïve HIV-1 infection, these functions could be impaired. In this study we assess the ability of NK cells from antiretroviral naïve HIV-1-infected people to respond to iRBC. Method Magnetically sorted NK cells from antiretroviral naïve HIV-1-infected people were tested for their ability to respond to iRBC following in vitro coculture. NK cell IFN-γ production after coculture was measured through multiparametric flow cytometry analysis. Results Our data show a significant reduction (p = 0.03) in IFN-γ production by NK cells from antiretroviral naïve HIV-1-infected people after coculture with iRBCs. This was in contrast to the NK cell response from healthy controls, which demonstrated elevated IFN-γ production. NK cell IFN-γ production from untreated HIV-1-infected participants correlated inversely with the viral load (r = −0.5, p = 0.02) and positively with total helper CD4+ T-cell count (r = 0.4, p = 0.04). Thus, antiretroviral naïve HIV-1 infection can dampen NK cell-mediated immunity to P. falciparum infection in malaria-intense regions. This could in effect escalate morbidity and mortality in people chronically infected with HIV-1.
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Affiliation(s)
- Carole Stéphanie Sake
- Laboratory of Vaccinology/Biobanking, CIRCB, Messa Yaounde, Cameroon.,Department of Microbiology, University of Yaoundé I, Yaoundé, Cameroon.,Department of Biochemistry, University of Yaoundé I, Yaoundé, Cameroon
| | - Loveline Ngu
- Laboratory of Vaccinology/Biobanking, CIRCB, Messa Yaounde, Cameroon.,Department of Biochemistry, University of Yaoundé I, Yaoundé, Cameroon
| | - Georgia Ambada
- Laboratory of Vaccinology/Biobanking, CIRCB, Messa Yaounde, Cameroon.,Department of Animal Biology and Physiology, University of Yaoundé I, Yaoundé, Cameroon
| | - Jean Paul Chedjou
- Department of Animal Biology and Physiology, University of Yaoundé I, Yaoundé, Cameroon.,The Biotechnology Center, University of Yaounde I, Yaoundé, Cameroon
| | - Nadesh Nji
- Laboratory of Vaccinology/Biobanking, CIRCB, Messa Yaounde, Cameroon
| | - Jules Colince Tchadji
- Laboratory of Vaccinology/Biobanking, CIRCB, Messa Yaounde, Cameroon.,Department of Animal Biology and Physiology, University of Yaoundé I, Yaoundé, Cameroon
| | - Abel Lissom
- Laboratory of Vaccinology/Biobanking, CIRCB, Messa Yaounde, Cameroon.,Department of Animal Biology and Physiology, University of Yaoundé I, Yaoundé, Cameroon
| | - Thibau Flaurant Tchouangueu
- Laboratory of Vaccinology/Biobanking, CIRCB, Messa Yaounde, Cameroon.,Department of Biochemistry, University of Dschang, Dschang, Cameroon
| | - Larissa Djukouo
- Laboratory of Vaccinology/Biobanking, CIRCB, Messa Yaounde, Cameroon.,Department of Biochemistry, University of Yaoundé I, Yaoundé, Cameroon
| | - Ghislain Njambe
- Laboratory of Vaccinology/Biobanking, CIRCB, Messa Yaounde, Cameroon.,Department of Animal Biology and Physiology, University of Yaoundé I, Yaoundé, Cameroon
| | - Rosario Garcia
- CSCB (Centre de santé catholique de Bikop), Bikop, Cameroon
| | - Anna Gutierrez
- CSCB (Centre de santé catholique de Bikop), Bikop, Cameroon.,Department of Biological Sciences, Alabama State University, Montgomery, AL, USA
| | - Alain Bopda Waffo
- Department of Biological Sciences, Alabama State University, Montgomery, AL, USA
| | - Chae Gyu Park
- Laboratory of Immunology, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Wilfried Mbacham
- Department of Biochemistry, University of Yaoundé I, Yaoundé, Cameroon.,The Biotechnology Center, University of Yaounde I, Yaoundé, Cameroon.,The Department of Biochemistry and Physiology, Faculty of Medicine, University of Yaounde I, Yaoundé, Cameroon
| | - François-Xavier Etoa
- Department of Microbiology, University of Yaoundé I, Yaoundé, Cameroon.,University of Douala, Douala, Cameroon
| | - Godwin W Nchinda
- Laboratory of Vaccinology/Biobanking, CIRCB, Messa Yaounde, Cameroon
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HIV-specific ADCC improves after antiretroviral therapy and correlates with normalization of the NK cell phenotype. J Acquir Immune Defic Syndr 2015; 68:103-11. [PMID: 25394194 DOI: 10.1097/qai.0000000000000429] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Natural killer (NK) cell phenotype and function have recently gained much attention as playing crucial roles in antibody-dependent cellular cytotoxicity (ADCC). We investigated NK cell function, as measured by ADCC, in HIV-1-positive individuals before and 6 months after highly active antiretroviral therapy (HAART) initiation. METHOD The ability of antibodies and NK cells to mediate ADCC was investigated separately and in combination in an autologous model. The NK cell subset distribution and NK cell phenotype (ie, expression of maturation and activation markers within NK cell subsets) were analyzed. RESULTS The ability of NK cells to mediate ADCC was significantly increased after only 6 months of HAART and was not explained by a normalization of NK cell subsets (CD56 CD16 and CD56 CD16 NK cells) but rather by normalization in the frequency of NK cells expressing CCR7 and CD27. For individuals with no increase in ADCC after 6 months of HAART, the frequency of NK cells expressing NKp46 was downregulated. The ability of antibodies to mediate ADCC alone and in combination in an autologous model was not improved. CONCLUSIONS HAART improves the ability of NK cells to mediate ADCC after 6 months. This improvement does not correlate with general immune restoration, as measured by CD4 T-cell counts, but rather to a decrease in the frequency of NK cells expressing CCR7 and CD27.
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Nabatanzi R, Bayigga L, Ssinabulya I, Kiragga A, Kambugu A, Olobo J, Joloba M, Kamya MR, Mayanja-Kizza H, Nakanjako D. Low antigen-specific CD4 T-cell immune responses despite normal absolute CD4 counts after long-term antiretroviral therapy an African cohort. Immunol Lett 2014; 162:264-72. [PMID: 25263953 DOI: 10.1016/j.imlet.2014.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/17/2014] [Accepted: 09/18/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND CD4 counts guide antiretroviral therapy (ART) initiation and prophylaxis for opportunistic infections. It is unclear whether normal CD4 counts translate to normalized immune responses among ART-treated adults. We compared antigen-specific CD4 T-cell immune responses among ART-treated adults with CD4≥500cells/μl, optimal immune responders (O-IR), and their age-matched healthy HIV-negative counterparts. METHODS In a sample-based case-control study, cryopreserved peripheral blood mononuclear cells from 15 O-IR after 7 years of ART and 15 healthy controls, were analyzed for CD4+ T-cell proliferation using CFSE dye and cytokine production. RESULTS CD4 T-cell proliferation, upon stimulation with PPD and pneumococcal polysaccharide antigen, was lower among O-IR relative to HIV-negative controls; p=0.016 and p=0.016 respectively. CD4 T-cell production of IL-2 was lower among O-IR relative to HIV-negative control p=0.002. CD4 T-cell proliferation upon stimulation with SEB and CMV antigens was similar among O-IR and HIV-negative controls p=0.971 and p=0.480, respectively, and so was IL-4 and IFN γ production; p=0.528 and p=0.892, respectively. CONCLUSION Seven years of suppressive ART caused partial CD4 T-cell function recovery in an African HIV treatment cohort, despite restoration of CD4 T-cell counts to levels≥500cells/μl. The role innate immunity in the recovery of immune function during long-term ART should be investigated to guide decisions on continued prophylaxis against opportunistic infections.
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Affiliation(s)
- Rose Nabatanzi
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Lois Bayigga
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Isaac Ssinabulya
- Department of Internal Medicine, Makerere University College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Agnes Kiragga
- Infectious Diseases Institute, Makerere University, Kampala, Uganda.
| | - Andrew Kambugu
- Infectious Diseases Institute, Makerere University, Kampala, Uganda.
| | - Joseph Olobo
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Moses Joloba
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda; Department of Internal Medicine, Makerere University College of Health Sciences, Makerere University, Kampala, Uganda; Infectious Diseases Institute, Makerere University, Kampala, Uganda.
| | - Moses R Kamya
- Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda; Department of Internal Medicine, Makerere University College of Health Sciences, Makerere University, Kampala, Uganda; Infectious Diseases Institute, Makerere University, Kampala, Uganda.
| | | | - Damalie Nakanjako
- Department of Internal Medicine, Makerere University College of Health Sciences, Makerere University, Kampala, Uganda; Infectious Diseases Institute, Makerere University, Kampala, Uganda.
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