Immunopathogenesis and Diagnosis of Tuberculosis and Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome during Early Antiretroviral Therapy

J.H. Elliott, K. Vohith, S. Saramony, C. Savuth, C. Dara, C. Sarim, S. Huffam, R. Oelrichs, P. Sophea, V. Saphonn, J. Kaldor, D.A. Cooper, M.C. Vun, Martyn French

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    BackgroundIn many settings, the benefits of antiretroviral therapy (ART) are reduced by the high early incidence of tuberculosis and tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS)MethodsWe used tuberculin skin testing and the QuantiFERON-TB Gold In-Tube assay to investigate cellular immune responses to purified protein derivative (PPD) and region of difference 1 (RD1) antigens during the first 24 weeks of ARTResultsTB-IRIS and ART-associated tuberculosis occurred in 15 of 75 (20%) and 11 of 231 (4.8%) participants at risk, respectively. Greater increases in interferon γ (IFN-γ) and skin test responses to PPD were seen at week 24 and 12 in participants with TB-IRIS (P⩽.04), respectively. Raw IFN-γ responses to RD1 antigens and PPD corrected for pre-ART CD4+ T cell counts were higher at all time points in individuals with ART-associated tuberculosis (P
    Original languageEnglish
    Pages (from-to)1736-1745
    JournalThe Journal of infectious diseases
    Issue number11
    Publication statusPublished - 2009


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