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HIV Infection Disrupts the Sympatric Host-Pathogen Relationship in Human Tuberculosis
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نویسنده
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fenner l. ,egger m. ,bodmer t. ,furrer h. ,ballif m. ,battegay m. ,helbling p. ,fehr j. ,gsponer t. ,rieder h.l. ,zwahlen m. ,hoffmann m. ,bernasconi e. ,cavassini m. ,calmy a. ,dolina m. ,frei r. ,janssens j.-p. ,borrell s. ,stucki d. ,schrenzel j. ,böttger e.c. ,gagneux s.
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منبع
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plos genetics - 2013 - دوره : 9 - شماره : 3
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چکیده
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The phylogeographic population structure of mycobacterium tuberculosis suggests local adaptation to sympatric human populations. we hypothesized that hiv infection,which induces immunodeficiency,will alter the sympatric relationship between m. tuberculosis and its human host. to test this hypothesis,we performed a nine-year nation-wide molecular-epidemiological study of hiv-infected and hiv-negative patients with tuberculosis (tb) between 2000 and 2008 in switzerland. we analyzed 518 tb patients of whom 112 (21.6%) were hiv-infected and 233 (45.0%) were born in europe. we found that among european-born tb patients,recent transmission was more likely to occur in sympatric compared to allopatric host-pathogen combinations (adjusted odds ratio [or] 7.5,95% confidence interval [95% ci] 1.21-infinity,p = 0.03). hiv infection was significantly associated with tb caused by an allopatric (as opposed to sympatric) m. tuberculosis lineage (or 7.0,95% ci 2.5-19.1,p<0.0001). this association remained when adjusting for frequent travelling,contact with foreigners,age,sex,and country of birth (adjusted or 5.6,95% ci 1.5-20.8,p = 0.01). moreover,it became stronger with greater immunosuppression as defined by cd4 t-cell depletion and was not the result of increased social mixing in hiv-infected patients. our observation was replicated in a second independent panel of 440 m. tuberculosis strains collected during a population-based study in the canton of bern between 1991 and 2011. in summary,these findings support a model for tb in which the stable relationship between the human host and its locally adapted m. tuberculosis is disrupted by hiv infection. © 2013 fenner et al.
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آدرس
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institute of social and preventive medicine,university of bern,bern, Switzerland, institute of social and preventive medicine,university of bern,bern, Switzerland, mycobacteriology unit,institute for infectious diseases,university of bern,bern, Switzerland, department of infectious diseases,bern university hospital,university of bern,bern, Switzerland, institute of social and preventive medicine,university of bern,bern, Switzerland, division of infectious diseases and hospital epidemiology,university hospital of basel,basel, Switzerland, division of communicable diseases,federal office of public health,bern, Switzerland, division of infectious diseases,university hospital zurich,zurich,switzerland,university of zurich,zurich, Switzerland, institute of social and preventive medicine,university of bern,bern, Switzerland, institute of social and preventive medicine,university of zurich,zurich,switzerland,the union,paris, France, institute of social and preventive medicine,university of bern,bern, Switzerland, division of infectious diseases,kantonsspital st. gallen,st. gallen, Switzerland, division of infectious diseases,ospedale regionale lugano,lugano, Switzerland, division of infectious diseases,university hospital lausanne,lausanne, Switzerland, division of infectious diseases,university hospital geneva,geneva, Switzerland, cantonal institute of microbiology,bellinzona, Switzerland, department of clinical microbiology,university hospital of basel,basel, Switzerland, division of pneumology,university hospital geneva,geneva, Switzerland, department of medical parasitology and infection biology,swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland, department of medical parasitology and infection biology,swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland, laboratory of bacteriology,university hospital of geneva,geneva, Switzerland, institute of medical microbiology,national center for mycobacteria,university of zurich,zurich, Switzerland, department of medical parasitology and infection biology,swiss tropical and public health institute,basel,switzerland,university of basel,basel, Switzerland
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Authors
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