Hernandez-Munoz, Haydee Esperanza; (1999) Serological aspects of the association between HIV and mycobacterial infections. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Mycobacterial infections today are a global challenge particularly due to the increase of opportunistic infections in immune suppressed patients. New strains of mycobacteria have been identified from AIDS patients which cannot be cultured; but with the advantages of molecular techniques these strains have been identified and classified. Mycobacteria abound in the environment, coming into contact with all inhabitants and then creating protection in the normal population. However, in the immune suppressed population the susceptibility to develop disease is greater. Today the spectre of Mycobacterium tuberculosis has caused the World Health Organization to declare tuberculosis a global emergency. This is shown in the current global re-emergence of tuberculosis, with more than 3 million deaths annually in developing countries and a health problem in many industrialized nation; particularly as a result of the association between tuberculosis and the HIV/AIDS pandemic and the emergence of multidrug resistant strains. Numerous studies has been started with the emphasis on direct control and treatment, to avoid the problems caused by non-compliance and the creation of new drug-resistant strains, particularly with the high risk factor of progression of dormant bacilli to clinical infection in AIDS patients. One possible solution is to identify susceptibility, or to find a marker in the AIDS population to identify those patients who will develop mycobacterial infection. The aims of this study were to determine the antibody levels in AIDS patients in order to try to identify those at risk of developing mycobacterial infection and to review the responses to treatment and injection with M. vaccae as an immunotherapeutic. The aims were addressed by performing a detailed study of Mycobacterium avium and Mycobacterium tuberculosis in relation to HIV seropositivity and development of co-infection with one of these organisms. Using serum samples collected from AIDS patients co-infected with M.avium from the Middlesex Hospital, London, the susceptibility to co-infection with M. avium was studied. A second study was performed with patients enrolled in a trial of immunotherapy with M. vaccae.

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