PMID- 18077835
OWN - NLM
STAT- MEDLINE
DCOM- 20080124
LR  - 20200930
IS  - 1525-4135 (Print)
IS  - 1525-4135 (Linking)
VI  - 46
IP  - 4
DP  - 2007 Dec 1
TI  - Immune reconstitution inflammatory syndrome: risk factors and treatment 
      implications.
PG  - 456-62
AB  - BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS), also called 
      immune restoration disease, occurs in a subset of HIV-infected patients after the 
      initiation of highly active antiretroviral therapy (HAART) and can be 
      diagnostically challenging and difficult to treat. We sought to determine 
      clinical risk factors for the development of IRIS. METHODS: Patients from the 
      Johns Hopkins HIV Clinic who had IRIS were identified and matched with 4 controls 
      without IRIS who had initiated HAART within 6 months of the case. RESULTS: 
      Forty-nine cases of IRIS were identified; patients presented a median of 29 days 
      from the initiation of HAART (range: 4 to 186 days). A multivariate analysis 
      showed that the development of IRIS was independently associated with using a 
      boosted protease inhibitor (BPI) (odds ratio [OR] = 7.41; P = 0.006), a nadir CD4 
      count <100 cells/mm(3) (OR = 6.2; P < 0.001), and a plasma HIV viral RNA decrease 
      of more than 2.5 log at the time of IRIS compared with RNA levels before the 
      initiation of HAART. Incrementally greater decreases in viral loads directly 
      correlated with increased risk for the development of IRIS. CONCLUSIONS: The most 
      immunosuppressed patients treated with the most potent regimens, particularly 
      BPI-based regimens, resulting in significant HIV viral load declines are at 
      greatest risk for the development of IRIS after HAART initiation.
FAU - Manabe, Yukari C
AU  - Manabe YC
AD  - Center for Tuberculosis Research, Division of Infectious Diseases, School of 
      Medicine, Johns Hopkins University, Baltimore, MD 21231, USA. ymanabe@jhmi.edu
FAU - Campbell, James D
AU  - Campbell JD
FAU - Sydnor, Emily
AU  - Sydnor E
FAU - Moore, Richard D
AU  - Moore RD
LA  - eng
GR  - K24 DA00432/DA/NIDA NIH HHS/United States
GR  - R01 DA11602/DA/NIDA NIH HHS/United States
GR  - R01 HL71554/HL/NHLBI NIH HHS/United States
GR  - R21 AA105032/AA/NIAAA NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
RN  - 0 (Adrenal Cortex Hormones)
SB  - IM
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Adult
MH  - Analysis of Variance
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Female
MH  - HIV Infections/*drug therapy/etiology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/drug therapy/*epidemiology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Regression Analysis
MH  - Risk Factors
MH  - Time Factors
EDAT- 2007/12/14 09:00
MHDA- 2008/01/25 09:00
CRDT- 2007/12/14 09:00
PHST- 2007/12/14 09:00 [pubmed]
PHST- 2008/01/25 09:00 [medline]
PHST- 2007/12/14 09:00 [entrez]
AID - 10.1097/qai.0b013e3181594c8c [doi]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2007 Dec 1;46(4):456-62. doi: 
      10.1097/qai.0b013e3181594c8c.