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Oxford University Press, Clinical Infectious Diseases, 7(55), p. 1004-1011, 2012

DOI: 10.1093/cid/cis577

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Corticosteroid therapy, vitamin D status, and inflammatory cytokine profile in the HIV-tuberculosis immune reconstitution inflammatory syndrome

Journal article published in 2012 by Anali Conesa-Botella, Graeme Meintjes, Anna K. Coussens ORCID, Helen van der Plas, Rene Goliath, Charlotte Schutz, Mario Rodrigo Moreno Reyes, Meera Mehta, Adrian R. Martineau, Robert J. Wilkinson ORCID, Robert Colebunders, Katalin A. Wilkinson
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Background. Tuberculosis-immune reconstitution inflammatory syndrome (TB-IRIS) in patients coinfected with human immunodeficiency virus (HIV) and tuberculosis starting antiretroviral therapy (ART) is associated with hypercytokinemia. As adjunctive corticosteroid therapy and vitamin D have immunomodulatory properties, we investigated the relationship between cytokine/chemokine profiles, corticosteroid use, and vitamin D deficiency in TB-IRIS patients. Methods. Plasma from 39 TB-IRIS and 42 non-IRIS patients was collected during a prospective study of HIV-associated tuberculosis patients starting ART. In total, 26% of patients received corticosteroid (CTC) therapy pre-ART for severe tuberculosis. Concentrations of total 25-hydroxyvitamin D (25(OH) D) and 14 cytokines/chemokines were determined at ART initiation and 2 weeks later. Results. Patients prescribed concurrent CTC had lower interferon gamma (IFN-gamma), IP-10, tumor necrosis factor (TNF), interleukin (IL)-6, IL-8, IL-10, IL-12p40, and IL-18 pre-ART (P