THAA0202 | IMPACT OF TB CO-INFECTIONS (HIV, HBV, COVID-19) ON DRUG RESISTANCE AND IMMUNE RESPONSE IN PULMONARY TUBERCULOSIS PATIENTS IN CAMEROON

Diane Kamdem Thiomo^1|2, Marceline Djuidje Ngouniue^1|3, Jean Paul Assam Assam^1|4, Axel Cyriaque Ambassa^1|2, Lionel Ulrich Tiani^1|2, Genevieve Andoseh^1|2, Veronique Penlap Beng^1|2 | ¹Department of Biochemistry, Faculty of Science, University of Yaoundé I, Yaounde, Cameroon; ²Laboratory for Tuberculosis Research and Pharmacology, Biotechnology Center of Nkolbisson, Yaounde, Cameroon; ³Research and Health Ethics Committee in Central Africa (CERSAC), Yaoundé, Cameroon; ⁴Faculty of Agronomy and Agricultural Sciences, University of Dschang, Dschang, Cameroon

Tuberculosis is a transmissible infectious disease caused by Mycobacterium tuberculosis; despite the decrease in the incidence of this disease, morbidity and mortality still remain high. This study aimed to investigate anti-tuberculosis drug resistance and immune response in patients co-infected with HIV, COVID-19, HBV, and TB. A prospective cohort was conducted from September 2022 to December 2023, involving the collection of sputum, blood, and nasopharyngeal samples from 300 pulmonary tuberculosis patients recruited at Jamot Hospital in Yaoundé. HIV serological analysis, COVID-19 antigen test, and HBV surface antigen determination were performed by immunochromatography. The sputum, after collection and decontamination with cetylpyridinium chloride (CPC 1%), was cultured on Löwenstein-Jensen and Colestos media. Sensitivity tests to usual anti-tuberculosis drugs were carried out using the proportion method. Finally, the quantification of cytokines (IL1β, IL2, IL4, IL5, IL6, IL12P70, IL13, IL18, TNFα, INFY, and GM CSF) was done by Luminex technology. The results obtained from the investigations made it possible to observe that of the 300 patients recruited, a frequency of 69.3% (208/300) of mono-infected TB was obtained. The frequencies of TB/HIV, TB/HBV, TB/COVID-19, TB/HIV/HBV and TB/HIV/COVID-19 co-infections were 17.7% (53), 9.7% (29), 0.7% (2), 2.3% (7) and 0.3% (1). From 300 sputa cultured on Löwenstein-Jensen and Colestos media, 260 (86.7%) presented positive cultures. Analysis of overall resistance in the cultures obtained indicated a rate of 10% (15/150) and multi-resistance of 5.33% (8/150). Quantification of cytokines showed a significant elevation of IL-12p70 (113.5 ± 84.99), IL-5 (18.86 ± 6.57), IL-1β (10.68 ± 15.31) and IL-6 (113.5 ± 84.99) in the TB/HBV group compared to IFN-γ (22.81 ± 15.48), IL-18 (500.4 ± 378.9), and GM-CSF (22.81 ± 15.48) in the TB/HIV group, with p≤0.05. This study reveals a high prevalence of TB/HIV and TB/HBV co-infections, with notable drug resistance and distinct cytokine profiles suggesting differential immune responses. These findings point out the need for integrated co-infection screening, resistance monitoring, and immunological assessment to optimize TB patient management.