PMID- 15750393
OWN - NLM
STAT- MEDLINE
DCOM- 20050503
LR  - 20190718
IS  - 0269-9370 (Print)
IS  - 0269-9370 (Linking)
VI  - 19
IP  - 4
DP  - 2005 Mar 4
TI  - Incidence and risk factors for immune reconstitution inflammatory syndrome during 
      highly active antiretroviral therapy.
PG  - 399-406
AB  - BACKGROUND: There is little systematic information regarding the immune 
      reconstitution inflammatory syndrome (IRIS). OBJECTIVE: To determine the 
      incidence, risk factors, and long-term outcome of IRIS in HIV-infected patients 
      receiving highly active antiretroviral therapy (HAART) who were coinfected with 
      one of three common opportunistic pathogens. DESIGN: A retrospective cohort 
      identified through a city-wide prospective surveillance program. METHODS: A 
      retrospective chart review was performed for 180 HIV-infected patients who 
      received HAART and were coinfected with Mycobacterium tuberculosis, Mycobacterium 
      avium complex, or Cryptococcus neoformans between 1997 and 2000. Medical records 
      were reviewed for baseline demographics, receipt and type of HAART, response to 
      antiretroviral therapy, development of IRIS, and long-term outcome. RESULTS: In 
      this cohort, 31.7% of patients who received HAART developed IRIS. Patients with 
      IRIS were more likely to have initiated HAART nearer to the time of diagnosis of 
      their opportunistic infection (P < 0.001), to have been antiretroviral naive at 
      time of diagnosis of their opportunistic infection (P < 0.001), and to have a 
      more rapid initial fall in HIV-1 RNA level in response to HAART (P < 0.001). 
      CONCLUSIONS: IRIS is common among HIV-infected persons coinfected with M. 
      tuberculosis, M. avium complex, or C. neoformans. Antiretroviral drug-naive 
      patients who start HAART in close proximity to the diagnosis of an opportunistic 
      infection and have a rapid decline in HIV-1 RNA level should be monitored for 
      development of this disorder.
FAU - Shelburne, Samuel A
AU  - Shelburne SA
AD  - Department of Medicine, Section of Infectious Diseases, University of Texas 
      Health Science Center at Houston, Texas 77030-4211, USA.
FAU - Visnegarwala, Fehmida
AU  - Visnegarwala F
FAU - Darcourt, Jorge
AU  - Darcourt J
FAU - Graviss, Edward A
AU  - Graviss EA
FAU - Giordano, Thomas P
AU  - Giordano TP
FAU - White, A Clinton Jr
AU  - White AC Jr
FAU - Hamill, Richard J
AU  - Hamill RJ
LA  - eng
GR  - K23-MH067505/MH/NIMH NIH HHS/United States
GR  - T32-AI055413/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - England
TA  - AIDS
JT  - AIDS (London, England)
JID - 8710219
RN  - 0 (RNA, Viral)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*complications/immunology
MH  - Adult
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - CD4 Lymphocyte Count
MH  - Female
MH  - HIV Infections/drug therapy/immunology/virology
MH  - HIV-1/isolation & purification
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Prognosis
MH  - RNA, Viral/blood
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Systemic Inflammatory Response Syndrome/epidemiology/*etiology
MH  - Texas/epidemiology
MH  - Viral Load
EDAT- 2005/03/08 09:00
MHDA- 2005/05/04 09:00
CRDT- 2005/03/08 09:00
PHST- 2005/03/08 09:00 [pubmed]
PHST- 2005/05/04 09:00 [medline]
PHST- 2005/03/08 09:00 [entrez]
AID - 00002030-200503040-00005 [pii]
AID - 10.1097/01.aids.0000161769.06158.8a [doi]
PST - ppublish
SO  - AIDS. 2005 Mar 4;19(4):399-406. doi: 10.1097/01.aids.0000161769.06158.8a.