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2014 ; 30
(12
): 1197-202
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The immune pathogenesis of immune reconstitution inflammatory syndrome associated
with highly active antiretroviral therapy in AIDS
#MMPMID25131160
Zheng Y
; Zhou H
; He Y
; Chen Z
; He B
; He M
AIDS Res Hum Retroviruses
2014[Dec]; 30
(12
): 1197-202
PMID25131160
show ga
The present study investigated the immunological pathogenesis of immune
reconstitution inflammatory syndrome (IRIS) in acquired immunodeficiency syndrome
(AIDS) patients undergoing highly active antiretroviral therapy (HAART). A total
of 238 patients with AIDS who received initial HAART were included in this
prospective cohort study. Blood samples were collected immediately, at baseline,
at week 12, and at week 24 after initial HAART and at the onset of IRIS.
Lymphocyte subsets, Th1 and Th2 cytokines, and interleukin (IL)-7 levels were
measured by flow cytometry or ELISA. Among the 238 patients with AIDS who
received HAART, 47 patients developed IRIS. The percentages of CD4(+) and CD8(+)
naive, memory, and activated cells exhibited no significant differences between
AIDS patients with and without IRIS 24 weeks after initial HAART. The percentage
of CD4(+)CD25(+)Foxp3(+) regulatory T cells was lower in IRIS patients than in
non-IRIS patients before HAART, 12 weeks after HAART, 24 weeks after HAART, and
at the onset of IRIS. IL-2 and interferon (IFN)-? levels were significantly
higher at week 4 and at the onset of IRIS in IRIS patients than in non-IRIS
patients. In contrast, IL-4 and IL-10 levels were significantly lower at week 4
and at the onset of IRIS in IRIS patients than in non-IRIS patients. Plasma IL-7
decreased gradually with the progression of HAART. The level of IL-7 was higher
in IRIS patients than in non-IRIS patients at all follow-up time points. An
imbalance of Th1/Th2 cytokines, a consistently low CD(+)CD25(+)Fox3(+)
percentage, and a high IL-7 level may be crucial in the pathogenesis of IRIS in
AIDS patients who had received HAART.