Kinetics of sedimentation rate, viral load and TNF-α in relation to HIV co-infection in tuberculosis

The kinetics of potential surrogate markers in HIV-positive (HIV+) and HIV-negative (HIV−), smear-positive tuberculosis (Tb+) patients in Gondar, Ethiopia (n = 60) was investigated. Clinical symptoms, sputum conversion, sedimentation rate (SR), HIV viral load and serum levels of TNF-α were determined before and 8 weeks after treatment initiation. The co-infection rate of HIV was 45%. There were significantly higher initial levels of SR and TNF-α in HIV+/Tb+ patients (79 ± 29 mm/h and 13.5 ± 7.6 pg/ml), than in HIV−/Tb+ patients (60 ± 23 mm/h and 6.8 ± 5.9 pg/ml, P < 0.001). In HIV−/Tb+ patients, there was a marked decrease in SR compared with co-infected patients (46% [33 ± 24 mm/h at week 8] vs. 24% [61 ± 27 mm/h at week 8]). The HIV viral load (4.99 [range 3.70-5.92] to 4.90 [range 3.96-5.78] log10 copies/ml from week 0 to 8) and TNF-α (13.5 ± 7.6 to 12.0 ± 6.0 pg/ml) remained high in HIV+/Tb+ patients. In Tb patients, SR was significantly increased in HIV+ compared with HIV− patients. Additionally, TNF-α and HIV viral load remained elevated in HIV+/Tb+ patients following treatment despite clinical improvement comparable to HIV−/Tb+ patients.