Effect of toxoplasma co-inefected with intestinal helminthes on cell mediated immunity to tuberculosis patients

الملخص EN

The effect of intestinal helminthes (IH) and Toxoplasma gondii (Tox) co-infection on anti-mycobacterium tuberculosis (MTB) immunity in patients with active pulmonary tuberculosis was studied in 96 patients of 4 groups.

Thirteen patients had TB + IH + Tox (G1), 15 had TB + IH (G2), 21 had TB + Tox (G3) and 47 had TB (G4).

The mean diameter of tuberculin and toxoplasmin tests was measured to assess cell mediated immunity.

Anti-Toxoplasma IgG1 & IgG4 antibodies were sought in toxoplasmic patients by ELISA for Thelper1 (Th1) and Th2 cytokine responses respectively.

All patients were treated by 6 months anti-MTB therapy.

Specific anti-IH therapies were given for patients with concomitant IH.

Sputum examination for acid fast bacilli was done 2 weeks post-treatment and duration of sputum clearance was recorded.

The results showed that IH co-infection had significant negative effect on mean diameter of tuberculin test compared to G4 (5.870.08 vs 8.65 0.05mm ; P < 0.01).

Concurrent Tox with TB significantly increased tuberculin test mean diameter (10.89 0.11 vs 8.65 0.05mm ; P < 0.05).

Mean level of anti-Tox IgG1 among G3 was significantly higher than in G1 (0.88 0.05vs0.55 0.02 ; P < 0.001), but vice versa was with IgG4.

Mean tuberculin diameter increased significantly post-treatment in all Gs except G3.

Anti-Tox IgG1 showed significant increase (0.55 0.02 to 0.82 0.03 ; P < 0.001) but IgG4 showed significant decrease (0.62 0.07 to 0.45 0.06, P < 0.01) post-treatment in G1, but G3 was insignificantly affected.

The duration of sputum cle arance was significantly longer in patients with IH co-infection compared to G4 (291 vs 21.84.6 days ; P < 0.001).