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Infection and Immunity, February 2002, p. 869-877, Vol. 70, No. 2
0019-9567/01/$04.00+0     DOI: 10.1128/IAI.70.2.869-877.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Induction of an AIDS Virus-Related Tuberculosis-Like Disease in Macaques: a Model of Simian Immunodeficiency Virus- Mycobacterium Coinfection

Yun Shen,1 Dejiang Zhou,1 Laura Chalifoux,2 Ling Shen,3 Meredith Simon,2 Xuejun Zeng,1 Xioamin Lai,1 Yunyuan Li,1 Prabhat Sehgal,2 Norman L. Letvin,3 and Zheng W. Chen1*

Tuberculosis Research Unit, Beth Israel Deaconess Center,1 Harvard Medical School, Boston, Massachusetts 02215,3 New England Regional Primate Research Center, Southboro, Massachusetts 017722

Received 4 June 2001/ Returned for modification 31 July 2001/ Accepted 9 October 2001

The mechanism by which human immunodeficiency virus (HIV)-Mycobacterium tuberculosis coinfection facilitates development of HIV-related tuberculosis is poorly characterized. Macaque models of simian immunodeficiency virus (SIVmac)-Mycobacterium bovis BCG coinfection were employed to explore the pathogenesis of AIDS virus-related tuberculosis. Following BCG coinfection, SIV (SIV)-infected macaques with high viral loads developed an SIV-related tuberculosis-like disease. This disease was characterized clinically by a syndrome of diarrhea, anorexia, weight loss, and altered levels of consciousness and pathologically by the presence of disseminated granulomas. In contrast, SIVmac-infected macaques with low viral loads either showed no evidence of BCG-induced disease or developed focal granulomatous lesions. Pathogenic SIV-BCG interactions appeared to play a critical role in triggering the development of this SIV-related tuberculosis-like disease. BCG coinfection enhanced the destruction of CD4+ T cells in SIVmac-infected macaques whose viral loads were high. Reciprocally, exacerbations of SIV disease led to marked suppression of BCG-specific T-cell responses, persistence of the BCG infection, and development of an SIV-related tuberculosis-like disease. Furthermore, development of this SIV-related tuberculosis-like disease was also seen in naïve macaques simultaneously inoculated with SIVmac and BCG. These results provide in vivo evidence that coinfection of AIDS virus-infected individuals with an avirulent mycobacterium can lead to development of a tuberculosis-like disease.

* Corresponding author. Mailing address: 330 Brookline Ave., RE113, Boston, MA 02215. Phone: (617) 667-2061. Fax: (617) 667-8210. E-mail: zchen{at}caregroup.harvard.edu.

Editor: S. H. E. Kaufmann

Infection and Immunity, February 2002, p. 869-877, Vol. 70, No. 2
0019-9567/01/$04.00+0     DOI: 10.1128/IAI.70.2.869-877.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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