Patients who developed TBM-IRIS had higher concentrations of MMP-1, -3, -7, and -10 in their blood, while MMP-9 and TIMP-1 were higher in CSF relative to blood at the time of TBM diagnosis and at the time of starting ART, as well as at the time of developing TBM-IRIS symptoms, when their concentrations increased further. Here, TIMP1 is linked to meningeal tuberculosis.