A step forward in TB prediction for people living with HIV: Findings from the first large-scale proteome study in the SHCS
Tuberculosis (TB) continues to be one of the most serious health threats for people living with HIV. While TB is caused by a bacterial infection and can often be treated, it can become life-threatening for those whose immune systems are weakened by HIV. One of the key challenges is that we still cannot reliably predict who will go on to develop active TB disease before symptoms begin.
A recent study lead by Katharina Kusejko within the Swiss HIV Cohort Study (SHCS) represents a significant advance in addressing this problem. For the first time in the SHCS, researchers have used large-scale plasma proteomics—a method for analyzing the proteins in blood—to search for early biological signs that someone might develop TB. This study is the largest of its kind in the context of the SHCS and marks an important step in efforts to improve TB prevention in people living with HIV.
What was the study about?
Researchers analyzed stored blood samples from 91 people who later developed TB and compared them to 293 individuals in the SHCS who did not. These samples were taken 6 months to 4 years before any TB diagnosis. The team examined more than 1,000 proteins per sample to look for patterns that might predict TB risk in advance.
Using machine learning methods, they identified a specific pattern—or “signature”—in the blood proteins that was linked to a higher likelihood of developing TB. This pattern was especially marked by signs of systemic inflammation and activity in B cells, which are part of the immune system that produces antibodies. These changes appeared well before any clinical signs of TB, suggesting they could be useful early indicators.
Why is this important?
This study provides two key insights:
- Improved Risk Prediction: The identified proteome signature could help identify individuals at higher risk of TB, allowing for better-targeted preventive care.
- New Understanding of TB Biology: The findings highlight a role for B cell activity and antibody production in TB progression—an area that has received less attention until now. This could inform new research into TB prevention and treatment.