Much Needed HIV, Tuberculosis Test Development Is Underway

People with the human immunodeficiency virus (HIV) already have compromised immune systems, which increases the risk of contracting an additional illness. Tuberculosis (TB) is of particular concern to physicians, as it’s a leading cause of death in people with HIV worldwide.

The National Institutes of Health (NIH) has awarded a researcher at the Albert Einstein College of Medicine a five-year, $3.7 million grant to look further into the infections. The focus will be on identifying biomarkers that increase activity in the bacterium that causes TB, Mycobacterium tuberculosis (Mtb).

“While infection with HIV or TB is usually manageable, the combination of the two diseases is particularly deadly,” principal investigator Jacqueline M. Achkar, MD, MS, associate professor of medicine and of microbiology & immunology at Einstein, said in a news release. “The problem is that it’s not practical or even possible to give these medications to all those who are co-infected with HIV and TB. In addition, the protective effects are often not durable.”

According to the US Agency for International Development (USAID), around 34 million people have HIV worldwide and at least one-third are co-infected with Mtb. “There is an urgent need for a test that can detect increasing Mtb activity in people with HIV, which could help optimize the timing of preventive TB therapy and may increase its effectiveness,” Achkar said.

Previous research conducted by Achkar and her team, with the use of novel screening technology, led to finding more than 200 proteins in HIV-positive blood who also had active TB, but they were not observed in those with latent TB. So now the researchers will continue to investigate those results to find a specific set of host proteins and antibodies that are associated with the Mtb infection activity. Once that’s done, the results will help develop prototype tests as well as models for predicting which patients with HIV are at risk for TB.

“If we could measure the Mtb activity level in co-infected individuals and determine who is at risk for progression to active TB, we would have a better idea of when to intervene with TB drugs,” concluded Achkar, who is also an attending physician of medicine at Montefiore.

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