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Brief Report: Sex and HIV Modify Immune Activation Biomarkers in Ugandans Post-Tuberculosis
Rebecca A Abelman1, Jessica Fitzpatrick1, Josephine Zawedde2
1Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA.
Journal of Acquired Immune Deficiency Syndromes (1999)
|June 18, 2025
Summary
Men showed higher immune activation in tuberculosis (TB) without HIV. Post-treatment, women with HIV exhibited increased immune markers compared to men, suggesting sex-specific inflammatory responses in TB.
Area of Science:
- Immunology
- Infectious Diseases
- Public Health
Background:
- Sex and HIV status influence tuberculosis (TB) prevalence.
- Mechanisms behind these differences, particularly inflammatory responses, are not fully understood.
- Limited research exists on how sex and HIV impact TB-related inflammation.
Purpose of the Study:
- To investigate the influence of sex and HIV status on immune activation biomarkers in adults with pulmonary TB.
- To determine if sex differences in immune response to TB vary based on HIV status.
Main Methods:
- 151 adults with pulmonary TB (with and without HIV) in Uganda were studied.
- 12 immune activation biomarkers were measured at TB diagnosis and treatment completion.
- Multivariable regression models assessed associations between biomarkers and sex, stratified by HIV status.
Main Results:
- At baseline, men generally had higher biomarker levels; this differed by HIV status.
- At follow-up, women without HIV showed higher suPAR and sCD163.
- Women with HIV had elevated suPAR, CRP, and IP-10 post-treatment.
Conclusions:
- In the absence of HIV, men with TB exhibited greater immune activation than women.
- Following TB treatment, women with HIV showed a trend towards higher immune activation compared to men.
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