Biomarkers could predict death in AIDS patients with severe inflammation

Dec 21, 2010

A study in this week's PLoS Medicine suggests that AIDS patients with cryptococcal meningitis who start HIV therapy are predisposed to immune reconstitution inflammatory syndrome (IRIS) — an exaggerated inflammatory immune response that kills up to one-third of affected people — if they have biomarkers (biochemicals) in their blood showing evidence of a damaged immune system that is not capable of clearing the fungal infection.

David Boulware and Paul Bohjanen from the University of Minnesota, Minneapolis, USA, and their colleagues, David Meya and Andrew Kambugu, at Makerere University in Kampala, Uganda enrolled 101 Ugandans with and recent cryptococcal meningitis who had not previously received and compared biomarker patterns in individuals who did and did not subsequently develop IRIS after starting HIV therapy. 45% of patients developed IRIS of whom 36% died, while only 21% of patients who did not develop IRIS died.

Furthermore, the authors found that patients who later developed IRIS associated with cryptococcal meningitis after starting therapy had 4-fold higher baseline concentrations of cryptococcal antigen and lower levels of several inflammatory cytokines in their blood compared to patients who did not develop CM-IRIS.

The authors say: "This study suggests that prediction of IRIS or death may be possible with measurement of pre-antiretroviral therapy serum biomarkers." They add, "Although requiring validation, these biomarkers might be an objective tool to stratify the risk of CM-IRIS and death, and could be used clinically to guide when to start antiretroviral therapy or use prophylactic interventions."

Explore further: Cell-associated HIV mucosal transmission: The neglected pathway

More information: Boulware DR, Meya DB, Bergemann TL, Wiesner DL, Rhein J, et al. (2010) Clinical Features and Serum Biomarkers in HIV Immune Reconstitution Inflammatory Syndrome after Cryptococcal Meningitis: A Prospective Cohort Study. PLoS Med 7(12): e1000384. doi:10.1371/journal.pmed.1000384

add to favorites email to friend print save as pdf

Related Stories

Predicting fatal fungal infections

Jun 16, 2009

In a study published in The Journal of Infectious Diseases, researchers from Albert Einstein College of Medicine of Yeshiva University have identified cells in blood that predict which HIV-positive indivi ...

QUT researcher eyes off a biometric future

Dec 04, 2007

It is not science fiction to think that our eyes could very soon be the key to unlocking our homes, accessing our bank accounts and logging on to our computers, according to Queensland University of Technology researcher ...

Recommended for you

Cambodia orders probe into mass HIV infection

Dec 18, 2014

Cambodian Prime Minister Hun Sen on Thursday ordered a probe into an apparent mass HIV infection believed to have been spread by contaminated needles, as the number of suspected cases passed 100.

A fresh setback for efforts to cure HIV infection

Dec 17, 2014

Researchers are reporting another disappointment for efforts to cure infection with the AIDS virus. Six patients given blood-cell transplants similar to one that cured a man known as "the Berlin patient" have ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.