Unmasking tuberculosis-associated immune reconstitution inflammatory syndrome in HIV-1 infection after antiretroviral therapy

• Main Authors: Sakorn Pornprasert, Pranee Leechanachai, Virat Klinbuayaem, Prattana Leenasirimakul, Channat Promping, Prasit Inta, Siraporn Ajhan
• Format: Journal
• Published: 2018
• Subjects: Immunology and Microbiology; Medicine
• Online Access: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=78649522582&origin=inward; http://cmuir.cmu.ac.th/jspui/handle/6653943832/50929
• Institution: Chiang Mai University

The exaggerated immune response to the subclinical opportunistic microorganisms or their antigens can be found in HIV-1 infected patients after receiving antiretroviral (ARV) therapy. We report a case of unmasking tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) in the HIV-1 infected patient who had no previous history of mycobacterial infection. She had tuberculosis of intestines, peritoneum and mesenteric glands within 2 months of ARV. However, her sputum acidfast bacilli stain, sputum, blood and cervical lymph node aspiration cultures for mycobacterium were negative. Her CD4 cell count increased of from 46 cells/μL at baseline before receiving ARV to 155 cells/μL at month 6 of ARV. In addition, her plasma pro-inflammatory (IFN-γ and TNF-α) and anti-inflammatory (IL-10) cytokine measurement was supported the occurrence of immune restoration reaction. Therefore, the changing in these cytokine profiles may be an important marker of developing unmasking TB-IRIS.