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Completed
Role of T-Regulatory Cells in Immune Reconstitution Inflammatory Syndrome
FunderUK Research and Innovation
Funder Contribution £124,154.00
Duration30 Jun 2004 - 29 Jun 2008
Funded underMRC
Project codeMC_U190081975
Open Access mandatePublications: NoResearch data: No
Identifiers
Project timeline100%
Description
Antiretroviral therapy (ART) is live saving for people living with HIV. People who become infected with HIV live without treatment on average 8 10 years until they die, while with ART they have the potential of a normal life span. ART became available in the mid 1990s and is now increasingly available to people in Sub Saharan Africa.People starting ART typically feel stronger within weeks, as the virus is suppressed and their immune system strengthens. From studies in the developed world, it has been noted that about 1 in 5 people starting ART initially feels better but within months falls sick again, with symptoms such as fevers, cough, swollen lymph nodes, weakness, or many more. This is called the Immune Reconstitution Inflammatory Syndrome (IRIS) and appears to be the result of the immune system waking up. This overactive immune system now recognizes bacteria and other organisms that were present before starting ART. IRIS typically goes away on its own.The cause of IRIS is unknown, and we think it may be the result of a temporary imbalance in the type of white blood cells that are returning on therapy. We are following people starting ART during the first 6 months with repeated blood tests.So far, we have enrolled 62 of 70 patients, of whom 36 have completed 6 months of therapy. Of these, more than 90% reported having any symptoms, and 40% were found to have IRIS. Laboratory studies have not yet been completed although an interim analysis is in progress.We hope to understand why some people develop IRIS and to identify markers that help identify who is at risk for developing IRIS before they start ART, so they can be monitored closely and possibly be treated with anti-inflammatory medications.
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Antiretroviral therapy (ART) is live saving for people living with HIV. People who become infected with HIV live without treatment on average 8 10 years until they die, while with ART they have the potential of a normal life span. ART became available in the mid 1990s and is now increasingly available to people in Sub Saharan Africa.People starting ART typically feel stronger within weeks, as the virus is suppressed and their immune system strengthens. From studies in the developed world, it has been noted that about 1 in 5 people starting ART initially feels better but within months falls sick again, with symptoms such as fevers, cough, swollen lymph nodes, weakness, or many more. This is called the Immune Reconstitution Inflammatory Syndrome (IRIS) and appears to be the result of the immune system waking up. This overactive immune system now recognizes bacteria and other organisms that were present before starting ART. IRIS typically goes away on its own.The cause of IRIS is unknown, and we think it may be the result of a temporary imbalance in the type of white blood cells that are returning on therapy. We are following people starting ART during the first 6 months with repeated blood tests.So far, we have enrolled 62 of 70 patients, of whom 36 have completed 6 months of therapy. Of these, more than 90% reported having any symptoms, and 40% were found to have IRIS. Laboratory studies have not yet been completed although an interim analysis is in progress.We hope to understand why some people develop IRIS and to identify markers that help identify who is at risk for developing IRIS before they start ART, so they can be monitored closely and possibly be treated with anti-inflammatory medications.
