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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e31829f6df2
Basic and Translational Science

TB-IRIS After Initiation of Antiretroviral Therapy Is Associated With Expansion of Preexistent Th1 Responses Against Mycobacterium tuberculosis Antigens

Vignesh, Ramachandran PhD*; Kumarasamy, Nagalingeswaran MBBS, PhD*; Lim, Andrew PhD; Solomon, Suniti MD, FAMS; Murugavel, Kailapuri G. PhD*; Balakrishnan, Pachamuthu PhD*; Solomon, Sunil S. MPH, PhD‡,¶; Mayer, Kenneth H. MD§; Swathirajan, Chinnambedu R. MSc*; Chandrasekaran, Ezhilarasi MSc; Pradeep, Ambrose MBBS; Poongulali, Selvamuthu MBBS, DGO; Benson, Constance A. MD; French, Martyn A. MB, ChB, MD

Erratum

Erratum

In the article by Vignesh et al, appearing in JAIDS: Journal of Acquired Immune Deficiency Syndromes, Vol. 64, No. 3, pp. 241-248 entitled “TB-IRIS After Initiation of Antiretroviral Therapy Is Associated With Expansion of Preexistent Th1 Responses Against Mycobacterium tuberculosis Antigens”, the graphs in Figure 3 were accidentally duplicated, specifically, the left hand graphs in A and B are identical. The correct version of Figure 3 appears below.

JAIDS Journal of Acquired Immune Deficiency Syndromes. 67(1):e44, September 1, 2014.

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Abstract

Background: The role of T-cell responses against Mycobacterium tuberculosis antigens in tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is unclear.

Methods: Peripheral blood mononuclear cells from 45 HIV patients with treated TB, of whom 12 developed TB-IRIS, were collected at weeks 0, 2, and 6 of antiretroviral therapy (ART). Production of interferon-gamma (IFN-γ) and interleukin-2 by T cells after stimulation with purified protein derivative (PPD) or early secretory antigenic target-6 (ESAT-6) and T-cell expressions of CCR5 and CXCR3 were assessed by flow cytometry. IFN-γ and CXCL10 were assayed by enzyme-linked immunosorbent assay.

Results: TB-IRIS patients had higher proportions of PPD- and ESAT-6–reactive IFN-γ+CD4+ and CD3+CD4 T cells at weeks 0, 2, and 6. IFN-γ levels were also higher in peripheral blood mononuclear cell culture supernatants at all times with PPD but only at weeks 2 and 6 with ESAT-6. There were few differences for interleukin-2. CXCL10 levels in supernatants after PPD and ESAT-6 stimulation were only higher at week 6. CXCR3+/CCR5+CD4+ T cells were higher at week 2, and CCR5+CD4+ T cells were higher at week 6.

Conclusions: TB-IRIS is associated with Th1 responses against M. tuberculosis antigens by CD4+ and CD3+CD4 T cells that are present before ART and amplified afterward. It is unclear if these cause immunopathology or reflect a high pathogen load.

© 2013 by Lippincott Williams & Wilkins

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