Plasma but Not Cerebrospinal Fluid Interleukin 7 and Interleukin 5 Levels Pre-Antiretroviral Therapy Commencement Predict Cryptococcosis-Associated Immune Reconstitution Inflammatory Syndrome

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Abstract

Background Patients with human immunodeficiency virus/AIDS-associated cryptococcal meningitis (CM) frequently experience clinical deterioration, known as cryptococcosis-associated immune reconstitution inflammatory syndrome (C-IRIS), upon initiation of antiretroviral therapy (ART). The immunological mechanisms underlying C-IRIS are incompletely defined and no reliable predictive biomarkers exist. We investigated whether plasma or cerebrospinal fluid (CSF) levels of cytokines and chemokines predicted C-IRIS and are potential predictive biomarkers. Methods Patients with CM who experienced C-IRIS (N =27) upon ART initiation were compared to CD4 + T-cell count-matched patients without C-IRIS (N =27). Plasma and CSF collected pre-ART were assayed for cytokines and chemokines using a 17-plex Luminex kit or enzyme-linked immunosorbent assay. Cox proportional hazards regression and principal component analyses were also performed. Results Plasma interleukin (IL) 2, IL-4, IL-5, IL-7, IL-17, interferon-γ 3, and tumor necrosis factor-α levels were higher in C-IRIS patients compared to controls (all P

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Akilimali, N. A., Chang, C. C., Muema, D. M., Reddy, T., Moosa, M. Y. S., Lewin, S. R., … Ndung’U, T. (2017). Plasma but Not Cerebrospinal Fluid Interleukin 7 and Interleukin 5 Levels Pre-Antiretroviral Therapy Commencement Predict Cryptococcosis-Associated Immune Reconstitution Inflammatory Syndrome. Clinical Infectious Diseases, 65(9), 1551–1559. https://doi.org/10.1093/cid/cix598

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