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

    Access Status
    Open access via publisher
    Authors
    Oliver, B.
    Elliott, J.
    Price, Patricia
    Phillips, M.
    Cooper, D.
    French, M.
    Date
    2012
    Type
    Journal Article
    
    Metadata
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    Citation
    Oliver, B. and Elliott, J. and Price, P. and Phillips, M. and Cooper, D. and French, M. 2012. Tuberculosis after commencing antiretroviral therapy for HIV infection is associated with elevated CXCL9 and CXCL10 responses to Mycobacterium tuberculosis antigens.. JAIDS: Journal of Acquired Immune Deficiency Syndromes. 61 (3): pp. 287-292.
    Source Title
    JAIDS: Journal of Acquired Immune Deficiency Syndromes
    DOI
    10.1097/QAI.0b013e31826445ef
    ISSN
    1944-7884
    School
    School of Biomedical Sciences
    URI
    http://hdl.handle.net/20.500.11937/57014
    Collection
    • Curtin Research Publications
    Abstract

    Background: Commencing antiretroviral therapy (ART) in human immunodeficiency virus-infected patients with treated or unrecognized Mycobacterium tuberculosis disease may trigger tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) or ART-associated tuberculosis (ART-TB). We have shown that whole-blood interferon-gamma release assays may aid in the prediction and diagnosis of ART-TB. Here, we investigate interferon-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-γ 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.

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