TB IRIS

Pathogenesis and identification of predictive factors of TB-IRIS in HIV patients under HAART

Objective

To follow-up a cohort of Ugandan HIV-infected patients with and without active M tuberculosis infection in order to:

– Assess the value of clinical and biological markers of HIV infection and tuberculosis in predicting the occurrence of TB-IRIS
– Correlate the pathological inflammatory responses of TB-IRIS with incomplete or unbalanced reconstitution of M tuberculosis-specific T regulatory and T effector cells and with inappropriate M tuberculosis-induced activation of monocytes and macrophages.
– Translate the immunopathological patterns identified into novel and sensitive predictive factors for diagnosis and prevention of TB-IRIS.

Background

The Immune Reconstitution Inflammatory Syndrome (IRIS) is an undesirable effect of effective antiretroviral therapy (ART) in HIV-infected patients. It is a pathological inflammatory response against germs, which are “recognized” as new by the regenerating immune system in response to ART. Tuberculosis-associated IRIS (TB-IRIS) is expected to become a major cause of HIV-associated morbidity as an increasing number of patients have access to ART in areas where both HIV infection and TB are endemic. The lack of a clear-cut case-definition and reliable predictive markers make clinical management of TB-IRIS less efficient. The overall aim of this study is to understand the pathogenesis of TB-IRIS, and to define its determinants by conducting a comprehensive investigation of clinical, virological, immunological and molecular parameters in a cohort of HIV-infected patients with different levels of exposure to TB. The clinical presentation of TB-IRIS will be assessed and the predictive value of different biological markers of HIV infection and tuberculosis, will be evaluated. Parallel to the clinical studies, we will examine whether defective reconstitution patterns associated with TB-IRIS can be linked to 3 types of key player cells.

 

Summary

Name: TB IRIS : Pathogenesis and identification of predictive factors of TB-IRIS in HIV patients under HAART
Status: Closed
Principal Investigator: Prof. dr. P. Reiss
Departments(s): AMC Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS
Partners: – The Institute of Tropical Medicine Antwerp (ITM), Belgium

– Infectious Disease Institute (IDI) Kampala, Uganda

– The Clinic of Immunobiology and Laboratory of Vaccinology and Mucosal Immunity from the Université Libre de Bruxelles (ULB) Belgium

– The Flemisch Institute of Biotechnology (VIB), Belgium

– The Institut Pasteur of Lille (IPL), France

– The Joint Clinical research Centre (JCRC), Kampala, Uganda

Contact information: Project Manager: Friso Janssen

E-mail: f.janssen@aighd.org

Duration: Start date: 1 July 2007

Duration: 36 months

End date: 1 July 2010

Funded by: EU
Countries: Uganda
Publications: