PMID- 19589302
OWN - NLM
STAT- MEDLINE
DCOM- 20090915
LR  - 20220801
IS  - 1548-3576 (Electronic)
IS  - 1548-3568 (Linking)
VI  - 6
IP  - 3
DP  - 2009 Aug
TI  - Management of patients with the immune reconstitution inflammatory syndrome.
PG  - 162-71
AB  - A significant proportion of patients present with the immune reconstitution 
      inflammatory syndrome (IRIS) after commencing antiretroviral therapy (ART). This 
      syndrome is most frequently associated with infective causes. The lack of 
      evidence-based treatment guidelines poses challenges in the management of these 
      patients. Alternative causes for deterioration should be excluded, and 
      optimization of treatment for the underlying opportunistic infection is 
      essential. In addition, anti-inflammatory or immunomodulatory therapy may be 
      considered, particularly in severe cases. Corticosteroids, the only treatment for 
      which clinical trial data exist (for treating paradoxical tuberculosis-associated 
      IRIS), are the treatment most frequently used in IRIS. Limited anecdotal reports 
      of benefit exist for other agents, including NSAIDs, pentoxifylline, montelukast, 
      thalidomide, and hydroxychloroquine. Therapeutic procedures (eg, aspiration of 
      pus collections) play an important role in some patients. Interruption of ART may 
      be considered in life-threatening forms of IRIS.
FAU - Marais, Suzaan
AU  - Marais S
AD  - Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, 
      Observatory, 7925, South Africa.
FAU - Wilkinson, Robert J
AU  - Wilkinson RJ
FAU - Pepper, Dominique J
AU  - Pepper DJ
FAU - Meintjes, Graeme
AU  - Meintjes G
LA  - eng
GR  - 072070/WT_/Wellcome Trust/United Kingdom
GR  - 084323/WT_/Wellcome Trust/United Kingdom
GR  - MC_U117588499/MRC_/Medical Research Council/United Kingdom
GR  - U117588499(88499)/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Review
PL  - United States
TA  - Curr HIV/AIDS Rep
JT  - Current HIV/AIDS reports
JID - 101235661
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
MH  - Anti-Retroviral Agents/*adverse effects
MH  - HIV Infections/*drug therapy
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/diagnosis/etiology/*therapy
MH  - Immunologic Factors/therapeutic use
RF  - 52
EDAT- 2009/07/11 09:00
MHDA- 2009/09/16 06:00
CRDT- 2009/07/11 09:00
PHST- 2009/07/11 09:00 [entrez]
PHST- 2009/07/11 09:00 [pubmed]
PHST- 2009/09/16 06:00 [medline]
AID - 10.1007/s11904-009-0022-z [doi]
PST - ppublish
SO  - Curr HIV/AIDS Rep. 2009 Aug;6(3):162-71. doi: 10.1007/s11904-009-0022-z.