Publications & Reports

Tuberculosis after commencing antiretroviral therapy for HIV infection is associated with elevated CXCL9 and CXCL10 responses to Mycobacterium tuberculosis antigens.

Oliver BG, Elliott JH, Price P, Phillips M, Cooper DA, French MA
1School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia. 2Alfred Hospital, Melbourne, Australia. 3Burnet Institute, Melbourne, Australia. 4National Centre in HIV Epidemiology and Clinical Research, University of New

Abstract

: Abstract BACKGROUND:: Commencing antiretroviral therapy (ART) in HIV patients with treated or unrecognised Mycobacterium tuberculosis disease may trigger tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) or antiretroviral therapy-associated tuberculosis (ART-TB). We have shown that whole blood interferon-gamma (IFN-gamma) release assays may aid in the prediction and diagnosis of ART-TB. Here, we investigate IFN-gamma-inducible chemokines CXCL9 and CXCL10. METHODS:: CXCL9 and CXCL10 responses to region of difference 1 (RD1) antigens and purified protein derivative (PPD) were assayed in plasma from whole blood cultures collected before and after 4, 12 and 24 weeks of ART from 15 TB-IRIS cases, 11 ART-TB cases and matched controls. RESULTS:: Relative to matched controls, ART-TB cases had elevated CXCL10 responses to RD1 antigens pre-ART (P=0.02) and to PPD and RD1 antigens over 24 weeks of ART (P</=0.02 and P</=0.03). In contrast, TB-IRIS cases had higher CXCL10 responses to RD1 antigens before and after 4 weeks of ART only (P=0.04 for both). CXCL9 responses to PPD and RD1 antigens were similar but less pronounced in ART-TB cases and did not differ between TB-IRIS cases and controls. CXCL10 responses to RD1 antigens performed as well as, or better than, IFN-gamma responses in the prediction and diagnosis of ART-TB. CONCLUSIONS:: Tuberculosis after commencing ART is associated with increased CXCL10 and, to a lesser extent, CXCL9 responses to M. tuberculosis antigens. Assessment of antigen-induced CXCL10 responses to RD1 antigens may assist in the prediction and diagnosis of ART-TB.

Publication

  • Journal: Journal of Acquired Immune Deficiency Syndromes
  • Published: 22/06/2012
  • Volume: 61
  • Issue: 3
  • Pagination: 287-292

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