The effect of HIV exposure and infection on immunity to TB in children

TB-related morbidity and mortality is high in HIV-infected children; HIV-exposed uninfected (HEU) children are also at substantial risk of Mtb infection and TB disease. Anti-mycobacterial innate immune responses are poorly defined in BCG-immunized HIV-infected and HEU infants and may modify TB susceptibility. The proposed study will utilize specimens from unique cohorts of HIV-infected, HEU, and HIV-unexposed (HUU) children to determine predictors of anti-mycobacterial immunity (including HIV exposure, HIV infection, antiretroviral treatment, and other factors), the influence of HIV exposure or infection on trained immunity, and the effects of this immunity on susceptibility to TB.