Nasal and Blood Host Gene Expression in treatment-naive HIV-infected Adults with Pulmonary Tuberculosis in Uganda

This study explored whether nasal gene expression differed in ART-naive HIV-positive adults with pulmonary TB disease compared to HIV-positive adults without TB. 40 adults with newly diagnosed HIV and presumptive pulmonary TB were consecutively enrolled in Uganda: 20 with active TB disease and 20 without. Nasal cells and blood were collected for RNA sequencing. The study identified nasal differentially expressed genes (DEGs) and biological pathways between TB cases and control and assessed the performance of nasal gene signatures in classifying TB. As secondary objectives, the study compared nasal-derived DEGs, pathways and signatures with paired blood samples and evaluated the diagnostic performance of existing blood signatures in the nasal dataset. The overarching aim was to see if nasal samples could be a source of diagnostic biomarkers for TB. This is of global importance given that TB is the primary reason for death in people with HIV, partly due to difficulties in diagnosis.