{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T15:43:48Z","timestamp":1770911028847,"version":"3.50.1"},"posted":{"date-parts":[[2026,2,10]]},"group-title":"HIV\/AIDS","reference-count":81,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,2,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                    Tuberculosis (TB) is a leading cause of morbidity and mortality among children living with HIV (CLHIV). Poor diagnostic performance is a significant contributor. Serological assays that determine levels of\n                    <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                    reactive antibodies inconsistently detect TB. However, antigen-specific antibody Fc receptor engagement and effector functions are promising biomarkers of TB disease.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    This study evaluated serum from a well-characterized cohort of Kenyan CLHIV via two orthogonal approaches: 1) longitudinally following over the course of TB treatment and 2) assessing a cross-section with and without clinical TB disease. For each individual sample, 13 antibody functional properties against 8\n                    <jats:italic>Mtb<\/jats:italic>\n                    and 4 non-\n                    <jats:italic>Mtb<\/jats:italic>\n                    microbial antigens were measured and analyzed via univariate and multivariate machine-learning approaches.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>\n                    Fc\u03b1R\/CD89 immune complex formation with antibodies reactive to four\n                    <jats:italic>Mtb<\/jats:italic>\n                    antigens including ESAT-6 &amp; CFP-10, Fc\u03c8RI\/CD64 associated with one\n                    <jats:italic>Mtb<\/jats:italic>\n                    antigen, and HIV gp120 IgA1 levels decreased during the intensive and continuation\/consolidation phases of TB therapy. This antibody signature also highlighted treatment non-responsiveness and distinguished children with from those without TB disease with predictive capacity similar to Xpert.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>\n                    An\n                    <jats:italic>Mtb<\/jats:italic>\n                    and HIV reactive peripheral blood antibody functional signature of Fc\u03b1R\/CD89, Fc\u03c8RI\/CD64, and IgA1 has the potential to complement current clinical tools and those in development to diagnose pulmonary TB disease in CLHIV.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Funding<\/jats:title>\n                  <jats:p>This work is supported by UT Southwestern Disease Oriented Scholars Award (LLL), NIAID 5R01AI158858 (LLL), Burroughs-Wellcome Fund UTSW Training Resident Doctors as Innovators in Science (YJK), NICHD K12HD000850, NIAID K23AI143479 and R21AI192086 (LMC), NICHD R01 HD023412 (GJS), NIAID 75N93019C00071 (CW).<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.02.08.26345833","type":"posted-content","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:50:12Z","timestamp":1770771012000},"source":"Crossref","is-referenced-by-count":0,"title":["An Fc receptor and IgA functional signature identifies TB disease in children living with HIV"],"prefix":"10.64898","author":[{"given":"Ye jin","family":"Kang","sequence":"first","affiliation":[{"name":"Division of Pediatric Infectious Disease, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nannan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Immunology and Microbiology, University of Colorado Anshutz School of Medicine, Aurora, CO, 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