Name Projekt #1:
TB Prävalenz in Gefängnissen in Tansania mittels Xpert MTB/RIF Analysw
ProCort - Progression of HIV-Disease under Low Dose Corticosteroids
Name Projekt #2:
World Union TB Barcelona Oct 2014, OPP-443-01, TB burden in Tanzanian prisons
Präsentation Kongress #2:
Kasang (2014), "Effects of Prednisolone on CD4 Counts and HIV Disease Progression: A Two-Year Clinical Trial, CROI Boston
Kasang HIV patients treated with low-dose prednisolone, exhibit lower immune activation than untreated, BMC infectious disease 2012,12:14
Abstract Projekt #2:
Background: HIV-associated general immune activation is a strong predictor for HIV disease progression,suggesting that chronic immune activation may drive HIV pathogenesis. Consequently, immunomodulating agents may decelerate HIV disease progression.
Methods: In an observational study, we determined immune activation in HIV patients receiving low-dose (5 mg/day) prednisolone with or without highly-active antiretroviral therapy (HAART) compared to patients without prednisolone treatment.
Lymphocyte activation was determined by flow cytometry detecting expression of CD38 on CD8(+) T cells. The monocyte activation markers sCD14 and LPS binding protein (LBP) as well as inflammation markers soluble urokinase plasminogen activated receptor
(suPAR) and sCD40L were determined from plasma by ELISA.Results: CD38-expression on CD8+ T lymphocytes was significantly lower in prednisolone-treated patients compared to untreated patients (median 55.40% [percentile range 48.76-67.70] versus 73.34%
[65.21-78.92], p = 0.0011, Mann-Whitney test). Similarly, we detected lower levels of sCD14 (3.6 μg/ml [2.78-5.12] vs. 6.11 μg/ml [4.58- 7.70]; p = 0.0048), LBP (2.18 ng/ml [1.59-2.87] vs. 3.45 ng/ml [1.84-5.03]; p = 0.0386), suPAR antigen (2.17 μg/ml.
[1.65-2.81] vs. 2.56 μg/ml [2.24-4.26]; p = 0.0351) and a trend towards lower levels of sCD40L (2.70 pg/ml [1.90-4.00] vs. 3.60 pg/ml [2.95-5.30]; p = 0.0782). Viral load in both groups was similar (0.8 × 105 ng/ml [0.2-42.4 × 105] vs. 1.1 × 105
[0.5-12.2 × 105]; p = 0.3806). No effects attributable to prednisolone were observed when patients receiving HAART in combination with prednisolone were compared to patients who received HAART alone.Conclusions: Patients treated with low-dose prednisolone
display significantly lower general immune activation than untreated patients. Further longitudinal studies are required to assess whether treatment with low-dose prednisolone translates into differences in HIV disease progression.