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OBJECTIVE: The factors associated with the development of immune reconstitution inflammatory syndrome in HIV patients commencing antiretroviral therapy have not been fully elucidated. Using a longitudinal study design, this study addressed whether alteration in the levels of T regulatory cells contributed to the development of IRIS in a West African cohort of HIV-1 and HIV-2 patients. Seventy-one HIV infected patients were prospectively recruited to the study and followed up for six months. The patients were categorized as IRIS or non-IRIS cases following published clinical guidelines. The levels of T regulatory cells were measured using flow cytometry at baseline and all follow-up visits. Baseline cytokine levels of IL-2, IL-6, IFN-γ, TNF-α, MIP-1β, IL-1, IL-12, IL-13, and IL-10 were measured in all patients. RESULTS: Twenty eight percent of patients (20/71) developed IRIS and were predominantly infected with HIV-1. Patients developing IRIS had lower nadir CD4 T cells at baseline (p = 0.03) and greater CD4 T cell reconstitution (p = 0.01) at six months post-ART. However, the development of IRIS was not influenced by the levels of T regulatory cells. Similarly, baseline cytokine levels did not predict the onset of IRIS. CONCLUSION: The development of IRIS was not associated with differences in levels of T regulatory cells or baseline pro-inflammatory cytokines.

Original publication




Journal article


PLoS One

Publication Date





Adult, Cohort Studies, Female, Gambia, HIV Infections, Humans, Immune Reconstitution Inflammatory Syndrome, Interleukin-1, Interleukin-10, Interleukin-12, Interleukin-2, Interleukin-6, Male, T-Lymphocytes, Regulatory, Tumor Necrosis Factor-alpha