1. ≥18 years HIV+, cART-naïve First CM Intensive Ampho 14 d Consolidation 400mg Fluconazole 12 weeks Maintenance 200mg Fluconazole therapy W02 W04 W08 W12 W16 W20 W24 cART Neurological deterioration Probable C-IRIS Possible C-IRIS Not C-IRIS Blood CSF CD4+ T-cellsCD8+ T-cells CCR5 + FSC-ASSC-H CD8 + FSC-H CD3 + FSC-H CXCR3 + CD4 + GraphPad Prism  v5. FlowJo  v7.5. BD LSRII 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 d00 d14/W00 Poster WEPDA0104

2. Significantly higher proportions of CD4 + and CD8 + T-cells co-express CXCR3 and CCR5 in CSF than in blood CD4 + T-cellsCD8 + T-cells

3. Patients who developed probable/possible C-IRIS had significantly higher CSF/Blood ratios of CXCR3 + /CCR5 + CD4 + and CD8 + T-cells pre-cART commencement 40 patients with 52 ND events – categorised by 1 st ND event Probable C-IRIS2255.0% Possible C-IRIS717.5% Not C-IRIS1127.5%  CD4 + and CD8 + T em cells co-expressing CCR5 and CXCR3 are significantly enriched in CSF  Higher CSF/Blood ratios of CXCR3 + /CCR5 + CD4 + and CD8 + T cells pre- cART commencement 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