PMID- 16374213
OWN - NLM
STAT- MEDLINE
DCOM- 20060314
LR  - 20191109
IS  - 0951-7375 (Print)
IS  - 0951-7375 (Linking)
VI  - 19
IP  - 1
DP  - 2006 Feb
TI  - Immune reconstitution inflammatory syndrome in HIV.
PG  - 20-5
AB  - PURPOSE OF REVIEW: The purpose of this review is to describe the epidemiology, 
      clinical features, putative immune mechanisms and management of immune 
      reconstitution inflammatory syndrome (IRIS) using data published in the last 2 
      years. RECENT FINDINGS: Ever more conditions are reported as IRIS events. These 
      most frequently occur with mycobacterial (tuberculosis or Mycobacterium avium 
      complex infection) or cryptococcal disease (each in approximately 30% of cases). 
      Definitions have been proposed for its clinical diagnosis. These suffer from a 
      lack of prospective studies to support their predictive value. The 
      immunopathogenesis of IRIS appears to be related to the interaction between 
      HAART-induced changes in host immune response and the presence of (usually 
      microbial) antigen. Increasing evidence exists that this might be an anatomically 
      compartmentalized phenomenon, such that immune responses may be localized to 
      specific tissue sites such as the brain. This has implications for the use of 
      simple blood tests, such as CD4 count or change in viral load, when assessing 
      risk of IRIS. Treatment options include immune modulation, though supportive care 
      is typically all that is required, unless symptoms are prolonged, significant or 
      life-threatening. SUMMARY: IRIS is common and will become more so as HAART is 
      rolled out worldwide. Clear clinical definitions are required to avoid its 
      over-diagnosis due to misclassification of other conditions.
FAU - Lipman, Marc
AU  - Lipman M
AD  - Department of HIV and Respiratory Medicine, Royal Free Hospital, London, UK. 
      marc.lipman@royalfree.nhs.uk
FAU - Breen, Ronan
AU  - Breen R
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Infect Dis
JT  - Current opinion in infectious diseases
JID - 8809878
RN  - 0 (Antigens)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/etiology/*immunology
MH  - Antigens/immunology
MH  - *Antiretroviral Therapy, Highly Active
MH  - HIV Infections/drug therapy/*immunology
MH  - Humans
MH  - Inflammation/*immunology
MH  - Syndrome
RF  - 53
EDAT- 2005/12/24 09:00
MHDA- 2006/03/15 09:00
CRDT- 2005/12/24 09:00
PHST- 2005/12/24 09:00 [pubmed]
PHST- 2006/03/15 09:00 [medline]
PHST- 2005/12/24 09:00 [entrez]
AID - 00001432-200602000-00005 [pii]
AID - 10.1097/01.qco.0000200543.80712.01 [doi]
PST - ppublish
SO  - Curr Opin Infect Dis. 2006 Feb;19(1):20-5. doi: 
      10.1097/01.qco.0000200543.80712.01.