Host factors and susceptibility to mycobacterial disease

There are weak associations between mycobacterial disease and major histocompatibility complex (MHC) haplotypes. In leprosy, these seem to determine the type of disease which develops rather than overall susceptibility. In rodents, susceptibility is also linked to the bcg/Ity/Lsh gene, which affects aspects of the baseline state of macrophage activation, and may be involved with control or transport of nitric oxide. Susceptibility to M. tuberculosis is particularly sensitive to factors that decrease T cell function, such as severe stress leading to activation of the cytokine hypothalamo-pituitary-adrenal axis, protein malnutrition and immunosuppression. Tuberculosis occurs early during infection with HIV. Infection with the M. avium/intracellulare/scrofulaceum (MAIS) complex is seen when greater degrees of T cell dysfunction occur.

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