This research addresses the following goals:

(1) to develop an indepenent patient-centered translational research career focused on Tuberculosis (TB);

(2) to conduct Clinical investigations Of immunodiagnostic tests for TB In an International setting;

(3) to implement advanced biostatistical methods In Clinical studies; and

(4) to develop theoretical and practical skills In applied T-cell immunology.

Dr. Cattamanchi's research will focus on a lung-based approach to Immunodiagnosis of Active TB, expanding on recent data suggesting that (1) local rather than peripheral T-cell cytokine responses can better discriminate Active TB from both LTBI and other Respiratory Infections and (2) T-cell cytokine responses may be useful In monitoring response to TB treatment.

The study will enroll a large cohort of HIV-Infected Pulmonary TB suspects to address the following specific aims: (1) To compare the performance of local and peripheral T-cell Interferon-gamma release assay responses for the diagnosis of Pulmonary TB In Hiv-Infected Patients with negative sputum smear microscopy and (2) To define the M. TB-specific T-cell cytokine profile during the course of TB treatment In HIV-Infected Patients with Active Pulmonary TB. The participants will be drawn from a separate, NHLBI-funded study Of the causes Of Pneumonia In HIV-Infected Patients In Kampala, Uganda.

 This proposal is consistent with the NHLBI's mission to study pulmonary immune responses In HIVassociated pulmonary infections. The study may lead to new and improved approaches to diagnosing and treating Active TB In Sub-Saharan Africa and other parts of the world.