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Epidemiological differences exist between  Mycobacterium africanum  ( Maf )- and  Mycobacterium tuberculosis  ( Mtb )-infected patients, but to date, contributing host factors have not been characterised. We analysed clinical outcomes, as well as soluble markers and gene expression profiles in unstimulated, and ESAT6/CFP-10-, whole- Maf - and  Mtb -stimulated blood samples of 26  Maf - and 49  Mtb -HIV-negative tuberculosis patients before, and after 2 and 6 months of anti-tuberculosis therapy. Before treatment, both groups had similar clinical parameters, but differed in few cytokines concentration and gene expression profiles. Following treatment the body mass index, skinfold thickness and chest X-ray scores showed greater improvement in the  Mtb-  compared to  Maf -infected patients, after adjusting for age, sex and ethnicity (p = 0.02; 0.04 and 0.007, respectively). In addition, in unstimulated blood, IL-12p70,  IL12A  and  TLR9  were significantly higher in  Maf -infected patients, while IL-15, IL-8 and MIP-1α were higher in  Mtb -infected patients. Overnight stimulation with ESAT-6/CFP-10 induced significantly higher levels of IFN-γ and TNF-α production, as well as gene expression of  CCL4 ,  IL1B  and  TLR4  in  Mtb-  compared to  Maf -infected patients. Our study confirms differences in clinical features and immune genes expression and concentration of proteins associated with inflammatory processes between  Mtb - and  Maf -infected patients following anti-tuberculosis treatment These findings have public health implications for treatment regimens, and biomarkers for tuberculosis diagnosis and susceptibility.

Host Immune Responses Differ between M. africanum- and M. tuberculosis-Infected Patients following Standard Anti-tuberculosis Treatment