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≥18 years HIV+, c ART-naïve First CM

CD4 + and CD8 + T-cells co-expressing CXCR3 and CCR5 are increased in the cerebrospinal fluid relative to blood of HIV-infected patients with cryptococcal meningitis and associated with cryptococcal immune reconstitution inflammatory syndrome.

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≥18 years HIV+, c ART-naïve First CM

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  1. CD4+ and CD8+ T-cells co-expressing CXCR3 and CCR5 are increased in the cerebrospinal fluid relative to blood of HIV-infected patients with cryptococcal meningitis and associated with cryptococcal immune reconstitution inflammatory syndrome CC Chang, A Lim, S Omarjee, JH Elliott, BI Gosnell, WH Carr, MYS Moosa, T Ndung’u, SR Lewin, MA French • ≥18 years • HIV+, cART-naïve • First CM Neurological deterioration cART IntensiveAmpho 14 d Consolidation 400mg Fluconazole12 weeks Maintenance 200mg Fluconazole therapy W02 W04 W08 W12 W16 W20 W24 d00 d14/W00 Probable C-IRIS Possible C-IRIS Not C-IRIS Poster WEPDA0104 CD4+ T-cells CD8+ T-cells Blood CSF CXCR3+ GraphPad Prism  v5. BD LSRII FlowJo  v7.5. FSC-H CD3+ FSC-H CD4+ FSC-A SSC-H SSC-H CD8+ CCR5+

  2. Significantly higher proportions of CD4+ and CD8+T-cells co-express CXCR3 and CCR5 in CSF than in blood CD4+ T-cells CD8+ T-cells

  3. Patients who developedprobable/possible C-IRIS had significantly higher CSF/Blood ratios of CXCR3+/CCR5+CD4+ and CD8+ T-cells pre-cART commencement • CD4+ and CD8+ Tem cells co-expressing CCR5 and CXCR3 are significantly enriched in CSF • Higher CSF/Blood ratios of CXCR3+/CCR5+ CD4+ and CD8+ T cells pre-cARTcommencement predict the development of C-IRIS • Inhibitors of CXCR3 or CCR5 should be explored as preventative and therapeutic measures in C-IRIS Correspondence: Martyn.french@uwa.edu.au

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