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Research Abstracts Online
January 2009 - March 2010

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University of Minnesota Twin Cities
Medical School
Department of Medicine

PI: Daniel R. Boulware
Co-PI: Paul Bohjanen

Immune Reconstitution Inflammatory Syndrome in HIV-infected Persons in Resource-limited Areas

HIV Immune Reconstitution Inflammatory Syndrome (IRIS) is a newly recognized complication of anti-retroviral therapy (ART) whereby some persons initiating ART experience paradoxically clinical deterioration due to an exaggerated inflammatory response to occult, latent, or previously treated infections. HIV IRIS has emerged as a frequent complication of ART in sub-Saharan Africa. As cryptococcal meningitis (CM) is the second most common AIDS-defining illness in sub-Saharan Africa, CM-IRIS is a common problem. CM-IRIS is an ideal disease model for studying the epidemiology and pathogenesis of IRIS because CM-IRIS causes a distinct, easily recognized clinical syndrome characterized by a clear phenotype of aseptic meningitis. The characteristics of CM-IRIS can be studied at the site of inflammation by sampling cerebrospinal fluid (CSF) from the compartment where the inflammation occurs.

This project is a prospective cohort study of HIV-infected Ugandans with recent CM monitored on ART. The purpose is to determine if persons who develop IRIS have worse outcomes compared to persons who do not develop IRIS in a resource-limited area. The researchers will determine if HIV-infected Ugandan patients who develop CM-IRIS express biomarkers in their peripheral blood and CSF that can be used to diagnose IRIS or predict which patients are at risk of IRIS.

Group Members

Daniel Beisang, Graduate Student
Jonathan Jeschke, Research Associate
Bernd Rattenbacher, Research Associate
Julius R. SternJohn, Research Associate
Irina Vlasova, Research Associate
Darin Wiesner, Research Associate