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.
Publication types
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Randomized Controlled Trial
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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AIDS-Related Opportunistic Infections* / drug therapy
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AIDS-Related Opportunistic Infections* / epidemiology
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AIDS-Related Opportunistic Infections* / immunology
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AIDS-Related Opportunistic Infections* / microbiology
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Adult
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Antiretroviral Therapy, Highly Active
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Antitubercular Agents / therapeutic use
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Biomarkers / blood*
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Cytokines / blood*
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Female
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HIV Infections* / complications
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HIV Infections* / drug therapy
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HIV Infections* / epidemiology
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HIV Infections* / immunology
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Humans
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Immune Reconstitution Inflammatory Syndrome* / epidemiology
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Immune Reconstitution Inflammatory Syndrome* / immunology
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Immune Reconstitution Inflammatory Syndrome* / physiopathology
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Male
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Predictive Value of Tests
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Th1 Cells / immunology
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Th1 Cells / metabolism
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Thailand / epidemiology
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Treatment Outcome
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Tuberculosis* / complications
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Tuberculosis* / drug therapy
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Tuberculosis* / epidemiology
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Tuberculosis* / immunology
Substances
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Antitubercular Agents
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Biomarkers
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Cytokines