Immunologic markers as predictors of tuberculosis-associated immune reconstitution inflammatory syndrome in HIV and tuberculosis coinfected persons in Thailand.
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.
Tieu
Hong Van
HV
Department of Medicine, Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA. hvt2106@columbia.edu
Ananworanich
Jintanat
J
Avihingsanon
Anchalee
A
Apateerapong
Wichitra
W
Sirivichayakul
Sunee
S
Siangphoe
Umaporn
U
Klongugkara
Sukonsri
S
Boonchokchai
Benjawan
B
Hammer
Scott M
SM
Manosuthi
Weerawat
W
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
D000995:Antitubercular Agents; D015415:Biomarkers; D016207:Cytokines