title: Immunologic markers as predictors of tuberculosis-associated immune reconstitution inflammatory syndrome in HIV and tuberculosis coinfected persons in Thailand.
abstract: This study analyzes immunologic markers to predict and diagnose tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) in HIV and TB coinfected adults who initiated antiretroviral therapy (ART) in Thailand. T helper 1 cytokines interleukin (IL)-2, IL-12, and interferon-gamma (IFN-gamma) levels in response to PPD and RD1 antigens were assessed prior to ART, at weeks 6, 12, and 24 of treatment, and at time of TB-IRIS. Of 126 subjects, 22 (17.5%) developed TB-IRIS; 14 (64%) subjects received steroid treatment and 3 (14%) received NSAIDs; none of the subjects died. Median interval between ART initiation and TB-IRIS development was 14 days. IFN-gamma, IL-2, and IL-12 responses did not differ between TB-IRIS and no TB-IRIS subjects (p > 0.05). More research into the immunopathogenesis of TB-IRIS and diagnostic potential of cytokine markers is warranted.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. hvt2106@columbia.edu
authors.forename: Hong Van
authors.initials: HV
authors.lastname: Tieu
authors.forename: Jintanat
authors.initials: J
authors.lastname: Ananworanich
authors.forename: Anchalee
authors.initials: A
authors.lastname: Avihingsanon
authors.forename: Wichitra
authors.initials: W
authors.lastname: Apateerapong
authors.forename: Sunee
authors.initials: S
authors.lastname: Sirivichayakul
authors.forename: Umaporn
authors.initials: U
authors.lastname: Siangphoe
authors.forename: Sukonsri
authors.initials: S
authors.lastname: Klongugkara
authors.forename: Benjawan
authors.initials: B
authors.lastname: Boonchokchai
authors.forename: Scott M
authors.initials: SM
authors.lastname: Hammer
authors.forename: Weerawat
authors.initials: W
authors.lastname: Manosuthi
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000995:Antitubercular Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D016207:Cytokines / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology; D008297:Male; D011237:Predictive Value of Tests; D018417:Th1 Cells / Q000276:immunology / Q000378:metabolism; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology
chemical_list: D000995:Antitubercular Agents; D015415:Biomarkers; D016207:Cytokines