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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
HIV Infection Disrupts the Sympatric Host-Pathogen Relationship in Human Tuberculosis
PLoS Genetics, Volume 9, No. 3, Article e1003318, Year 2013
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Description
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. © 2013 Fenner et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3591267/bin/pgen.1003318.s001.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC3591267/bin/pgen.1003318.s002.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC3591267/bin/pgen.1003318.s003.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC3591267/bin/pgen.1003318.s004.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC3591267/bin/pgen.1003318.s005.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC3591267/bin/pgen.1003318.s006.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC3591267/bin/pgen.1003318.s007.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC3591267/bin/pgen.1003318.s008.pdf
Authors & Co-Authors
Fenner, Lukas
Switzerland, Bern
University of Bern
Egger, Matthias
Switzerland, Bern
University of Bern
Bödmer, Thomas
Switzerland, Bern
University of Bern
Furrer, Hansjakob
Switzerland, Bern
University of Bern
Ballif, Marie
Switzerland, Bern
University of Bern
Battegay, Manuel
Switzerland, Basel
Universitätsspital Basel
Helbling, Peter
Switzerland, Bern
Federal Office of Public Health Foph
Fehr, Jan Sven
Switzerland, Zurich
Universitatsspital Zurich
Switzerland, Zurich
Universität Zürich
Gsponer, Thomas
Switzerland, Bern
University of Bern
Rieder, Hans L.
Switzerland, Zurich
Universität Zürich
France, Paris
The Union
Zwahlen, Marcel
Switzerland, Bern
University of Bern
Hoffmann, Matthias
Unknown Affiliation
Bernasconi, Enos
Unknown Affiliation
Cavassini, Matthias L.
Switzerland, Lausanne
Centre Hospitalier Universitaire Vaudois
Calmy, Alexandra L.
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Frei, Reno
Switzerland, Basel
Universitätsspital Basel
Janssens, Jean Paul
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Borrell, Sònia
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Stucki, David
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Schrenzel, Jacques
Switzerland, Geneva
Hôpitaux Universitaires de Genève
Böttger, Erik Christian
Switzerland, Zurich
Universität Zürich
Gagneux, Sébastien P.
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Statistics
Citations: 64
Authors: 22
Affiliations: 11
Identifiers
Doi:
10.1371/journal.pgen.1003318
ISSN:
15537404
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Case-Control Study