PMID- 15958835
OWN - NLM
STAT- MEDLINE
DCOM- 20051219
LR  - 20220330
IS  - 0269-9370 (Print)
IS  - 0269-9370 (Linking)
VI  - 19
IP  - 10
DP  - 2005 Jul 1
TI  - Incidence and risk factors of immune reconstitution inflammatory syndrome 
      complicating HIV-associated cryptococcosis in France.
PG  - 1043-9
AB  - BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) in association 
      with cryptococcosis has been anecdotically reported following administration of 
      highly active antiretroviral therapy (HAART). OBJECTIVE: To analyse the incidence 
      and risk factors for IRIS-associated cryptococcosis among HIV-infected patients. 
      DESIGN: Retrospective multicentre study between 1996 and 2000 through the French 
      Cryptococcosis Database. METHODS: Subsequent occurrence of IRIS examined in 120 
      HIV-infected adult patients treated with HAART and experiencing a first episode 
      of culture-confirmed cryptococcosis. RESULTS: Ten patients developed IRIS during 
      the study period, giving an incidence of 10/239, or 4.2/100 person-years [95% 
      confidence interval (CI), 2.2-7.8]. IRIS consisted of acute symptoms consistent 
      with inflammation occurring within a median of 8 months (range, 2-37) after the 
      diagnosis of cryptococcosis in the context of negative cultures and immunological 
      and/or virological response to HAART. Radiology and histopathology detected 
      features compatible with inflammation. Symptom severity required transfer into 
      intensive care units for three patients and use of anti-inflammatory drugs for 
      four. Three patients with evolutive IRIS died. Compared with patients without 
      IRIS for whom complete clinical and microbiological information were available at 
      baseline, previously unknown HIV infection [odds ratio (OR), 4.8; 95% CI, 
      1.0-21.7], CD4 cell count < 7 x 10 cells/l (OR, 4.0; 95% CI, 0.9-17.2), fungaemia 
      (OR, 6.1; 95% CI, 1.1-35.2) and HAART initiation within 2 months of 
      cryptococcosis diagnosis (OR, 5.50; 95% CI, 1.0-29.6) were independently 
      associated with the risk of subsequent IRIS. CONCLUSIONS: IRIS-related 
      cryptococcosis was observed more frequently in severely immunocompromised 
      patients with disseminated infection and HAART initiation soon after the 
      diagnosis.
FAU - Lortholary, Olivier
AU  - Lortholary O
AD  - National Reference Centre for Mycoses and Antifungals, Molecular Mycology Unit 
      bEmerging Diseases Epidemiology Unit, Institut Pasteur, Paris, France. 
      olortho@pasteur.fr
FAU - Fontanet, Arnaud
AU  - Fontanet A
FAU - Memain, Nathalie
AU  - Memain N
FAU - Martin, Antoine
AU  - Martin A
FAU - Sitbon, Karine
AU  - Sitbon K
FAU - Dromer, Francoise
AU  - Dromer F
CN  - French Cryptococcosis Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - AIDS
JT  - AIDS (London, England)
JID - 8710219
RN  - 0 (Anti-Inflammatory Agents)
SB  - IM
CIN - AIDS. 2005 Nov 18;19(17):2050-2. PMID: 16260920
MH  - AIDS-Related Opportunistic Infections/*chemically induced
MH  - Adult
MH  - Anti-Inflammatory Agents/therapeutic use
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Critical Care
MH  - Cryptococcosis/*chemically induced/immunology
MH  - Female
MH  - HIV Infections/*drug therapy/immunology
MH  - Humans
MH  - Immune Tolerance/*drug effects
MH  - Incidence
MH  - Inflammation/*chemically induced
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Syndrome
EDAT- 2005/06/17 09:00
MHDA- 2005/12/20 09:00
CRDT- 2005/06/17 09:00
PHST- 2005/06/17 09:00 [pubmed]
PHST- 2005/12/20 09:00 [medline]
PHST- 2005/06/17 09:00 [entrez]
AID - 00002030-200507010-00009 [pii]
AID - 10.1097/01.aids.0000174450.70874.30 [doi]
PST - ppublish
SO  - AIDS. 2005 Jul 1;19(10):1043-9. doi: 10.1097/01.aids.0000174450.70874.30.