A T helper-1 (Th-1) type T lymphocyte response been shown by these investigators to be associated with a good outcome in TB patients. There is increasing evidence that HIV-infected patients have impaired Th-1 number and function, with a resultant deficiency in interferon-gamma (IFN-g), a key effector cytokine in host immunity in tuberculosis. The investigator hypothesizes that a Th-1 immune response locally limits Mycobacterium tuberculosis and that aerosol delivery of IFN-g to the lung will enhance the Th-1 response, thereby reducing M.tuberuclosis stimulated HIV-1 replication in the lung. The investigator aims to modulate the Th phenotype in bronchoalveolar lavage cells and HIV-1 replication in active pulmonary TB by aerosol treatment with IFN-g and to investigate the mechanisms by which IFN-g contributes to host defense against TB in both HIV-negative and HIV-positive individuals.
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