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TB-IRIS after initiation of antiretroviral therapy is associated with expansion of preexistent th1 responses against mycobacterium tuberculosis antigens

Journal of Acquired Immune Deficiency Syndromes, ISSN: 1525-4135, Vol: 64, Issue: 3, Page: 241-248
2013
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Conference Paper Description

BACKGROUND: The role of T-cell responses against Mycobacterium tuberculosis antigens in tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is unclear. METHODS: Peripheral blood mononuclear cells from 45 HIV patients with treated TB, of whom 12 developed TB-IRIS, were collected at weeks 0, 2, and 6 of antiretroviral therapy (ART). Production of interferon-gamma (IFN-γ) and interleukin-2 by T cells after stimulation with purified protein derivative (PPD) or early secretory antigenic target-6 (ESAT-6) and T-cell expressions of CCR5 and CXCR3 were assessed by flow cytometry. IFN-γ and CXCL10 were assayed by enzyme-linked immunosorbent assay. RESULTS: TB-IRIS patients had higher proportions of PPD- and ESAT-6-reactive IFN-γCD4 and CD3CD4 T cells at weeks 0, 2, and 6. IFN-γ levels were also higher in peripheral blood mononuclear cell culture supernatants at all times with PPD but only at weeks 2 and 6 with ESAT-6. There were few differences for interleukin-2. CXCL10 levels in supernatants after PPD and ESAT-6 stimulation were only higher at week 6. CXCR3/CCR5CD4 T cells were higher at week 2, and CCR5CD4 T cells were higher at week 6. CONCLUSIONS: TB-IRIS is associated with Th1 responses against M. tuberculosis antigens by CD4 and CD3CD4 T cells that are present before ART and amplified afterward. It is unclear if these cause immunopathology or reflect a high pathogen load. Copyright © 2013 by Lippincott Williams & Wilkins.

Bibliographic Details

Vignesh, Ramachandran; Kumarasamy, Nagalingeswaran; Lim, Andrew; Solomon, Suniti; Murugavel, Kailapuri G; Balakrishnan, Pachamuthu; Solomon, Sunil S; Mayer, Kenneth H; Swathirajan, Chinnambedu R; Chandrasekaran, Ezhilarasi; Pradeep, Ambrose; Poongulali, Selvamuthu; Benson, Constance A; French, Martyn A

Ovid Technologies (Wolters Kluwer Health)

Medicine

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