The role of micro-RNA in the diagnosis of HIV-associated immune reconstitution inflammatory syndrome

Abstract

Immune Reconstitution Inflammatory Syndrome (IRIS) arises from the restoration of antigen-specific immune responses following antiretroviral therapy (ART) and presents in two forms: paradoxical and unmasking IRIS. Currently, no definitive diagnostic method exists for IRIS, and diagnosis relies on clinical symptoms in the context of immunological and virological responses to ART. This study hypothesized that specific microRNAs (miRNAs) involved in viral control and inflammation could be informative in identifying IRIS. We investigated the expression of 10 candidate miRNAs (miR-155, miR-132a, miR-10a, miR-146a, miR-146b, miR-181a, miR-27a, and miR-375, miR-16-5p, miR-191-5p) in 28 HIV-positive patients before ART, at approximately six months post-ART, and upon development of inflammatory symptoms. Significant differential expression of miR-146a and miR-181a was observed in IRIS patients compared to those without IRIS. Using pre-ART CD4 count and viral load data, in addition to miR-146a and miR-181a expression data, 7 patients who presented with ambiguous cases could be classified into IRIS and non-IRIS groups. Of these 7 patients, 3 were classified as having developed IRIS. These findings suggest that miR-146a and miR-181a may serve as potential biomarkers for diagnosing or predicting IRIS, though further research is required to confirm their clinical utility.