Research

Polychromatic immunophenotypic characterization of T cell profiles among HIV-infected patients experiencing immune reconstitution inflammatory syndrome (IRIS)

David M Murdoch¹ , Melinda S Suchard² , Willem DF Venter³ , Patrick Mhlangu⁴ , Janet S Ottinger⁵ , Charles Feldman⁶ , Annelies Van Rie⁷ , Deborah K Glencross^2,4 , Wendy S Stevens² and Kent J Weinhold⁵

¹  Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina, USA

²  Department of Molecular Medicine and Haematology, University of the Witwatersrand and National Health Laboratory Services, Johannesburg, South Africa

³  Reproductive Health & HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa

⁴  Contract Laboratory Services, Johannesburg, South Africa

⁵  Department of Surgery and Immunology and the Duke University Center for AIDS Research (CFAR), Duke University, Durham, North Carolina, USA

⁶  Division of Pulmonology, Department of Medicine, Johannesburg Hospital and University of the Witwatersrand, Johannesburg, South Africa

⁷  Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

author email corresponding author email

AIDS Research and Therapy 2009, 6:16doi:10.1186/1742-6405-6-16

Published:	16 July 2009

Abstract

Objective

To immunophenotype CD4⁺ and CD8⁺ T cell sub-populations in HIV-associated immune reconstitution inflammatory syndrome (IRIS).

Design

Nested case-control immunological study.

Methods

ART-naïve HIV-infected patients were prospectively observed for IRIS during the first 6 months of ART. Twenty-two IRIS cases and 22 ART-duration matched controls were sampled for T cell immunophenotyping.

Results

IRIS cases demonstrated significantly lower CD4 cell counts compared to controls (baseline: 79 versus 142, p = 0.02; enrollment: 183 versus 263, p = 0.05, respectively) with no differences in HIV RNA levels. Within CD4⁺T cells, cases exhibited more of an effector memory phenotype compared to controls (40.8 versus 27.0%, p = 0.20), while controls trended towards a central memory phenotype (43.8 versus 30.8%, p = 0.07). Within CD8⁺ T cells, controls exhibited more central memory (13.9 versus 7.81%, p = 0.01, respectively) and effector (13.2 versus 8.8%, p = 0.04, respectively) phenotypes compared to cases, whereas cases demonstrated more terminal effectors than controls (28.8 versus 15.1%, p = 0.05). Cases demonstrated increased activation of CD8⁺ T cell effector memory, terminal effector, and effector subsets than controls (p = 0.04, 0.02, and 0.02, respectively).

Conclusion

CD4⁺ and CD8⁺ T cell subset maturational phenotypes were heterogeneous among IRIS cases and controls. However, IRIS cases demonstrated significant increases in activation of CD8⁺ T cell effector subpopulations.