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METHODS

The study setting was Khayelitsha, a township of Cape Town with exceptionally high TB and HIV prevalence. 35 asymptomatic adults, HIV-1 infected, anti-retroviral therapy (ART) naïve, CD4> 350/mm3 with evidence of LTBI (by Quantiferon Gold-in-tube (QFGIT)) but no evidence of active TB on chest radiograph or history of TB underwent 18F-FDG-PET/CT before and after preventive TB treatment. A structured report identified TB related PET/CT changes. Blood was drawn for RNA and also from age, sex and CD4 matched, HIV-1 infected, ART naïve controls with active tuberculosis and those that were tuberculin skin test and QFGIT negative, as well as HIV negative controls and HIV-1 infected controls established on ART. Transcriptional signatures were determined by microarray.

RESULTS

For the 35 asymptomatic participants, median CD4 count was 453/mm3, viral load (VL) 10800 copies/mL, age 31 …