Publications

Cutaneous leishmanias is (CL) patients coinfected with HIV are known to show a more severe, prolonged course of disease;the immunological basis is not known. We now assessed clinical features, sera and skin biopsies of HIV+and HIV-patients with CLto identify drivers of increased susceptibility to Leishmania. CL lesion numbers, surface, and healing duration were significantly increased in HIV+as compared to HIVpatients (2.5, 14 and>4-fold, respectively). Patients with HIV infection exhibited lower serum Leishmania-specific IgG levels and decreased IL-6 and IL-8.Most importantly, dramatically decreased numbers of CD4+T cells(approximately eightfold), but not CD8+cells, together with fewer CXCR3+Th1 cells, fewer Foxp3+ effector/regulatory T cells, and reduced levels of IFN-c expression were found in lesional skin. Ourfindings suggest that compromised CD4+T-cell responses may be responsible for worsened disease outcome leading to defects in parasite elimination in the absence of sufficient numbers of IFN-c-producing Th1 cells.