TB IRIS

Description

The Immune Reconstitution Inflammatory Syndrome (IRIS) is an undesirable effect of effective antiretroviral therapy (ART) in HIV-infected patients. It is a pathological inflammatory response against germs, which are “recognized” as new by the regenerating immune system in response to ART. Tuberculosis-associated IRIS (TB-IRIS) is expected to become a major cause of HIV-associated morbidity as an increasing number of patients have access to ART in areas where both HIV infection and TB are endemic. The lack of a clear-cut case-definition and reliable predictive markers make clinical management of TB-IRIS less efficient. The overall aim of this study is to understand the pathogenesis of TB-IRIS, and to define its determinants by conducting a comprehensive investigation of clinical, virological, immunological and molecular parameters in a cohort of HIV-infected patients with different levels of exposure to TB. The clinical presentation of TB-IRIS will be assessed and the predictive value of different biological markers of HIV infection and tuberculosis will be evaluated. Parallel to the clinical studies, we will examine whether defective reconstitution patterns associated with TB-IRIS can be linked to three types of key player cells.