PMID- 19997137
OWN - NLM
STAT- MEDLINE
DCOM- 20100105
LR  - 20091209
IS  - 0807-7096 (Electronic)
IS  - 0029-2001 (Linking)
VI  - 129
IP  - 23
DP  - 2009 Dec 3
TI  - [Immune reconstitution inflammatory syndrome and treatment of HIV infection].
PG  - 2484-7
LID - 10.4045/tidsskr.09.0190 [doi]
AB  - BACKGROUND: HAART (highly active antiretroviral therapy) may trigger a condition 
      known as IRIS (immune reconstitution inflammatory syndrome); i.e. a paradoxical 
      reaction to latent infections associated with reconstitution of the immune 
      system. The article provides an overview of the syndrome and discusses diagnosis, 
      risk factors and management. MATERIAL AND METHODS: The basis for the article was 
      literature identified through non-systematic searches in PubMed and clinical 
      experience. RESULTS: IRIS typically occurs some weeks to months after initiation 
      of HAART, usually in association with mycobacterial infections, cytomegalovirus, 
      Cryptococcus neoformans and Pneumocystis jirovecii. In principle, any pathogen 
      may cause a similar inflammatory response. Risk factors for IRIS include severe 
      immunodeficiency, high antigen burden and rapid immune response to HAART. The 
      prognosis is good. However, treatment of infections must not delay the initiation 
      of HAART, as such a delay may increase morbidity and mortality. HAART should be 
      continued unless symptoms are life-threatening or likely to cause permanent 
      sequelae. Corticosteroids may be helpful in cases with lesions in the central 
      nervous system, obstructive lymph nodes or increasing respiratory symptoms. 
      INTERPRETATION: Treatment of HIV infection has improved substantially, which 
      implies an increased number of patients developing IRIS. A quick diagnosis and 
      correct and timely treatment of opportunistic infections is important for the 
      prognosis.
FAU - Troseid, Marius
AU  - Troseid M
AD  - Medisinsk avdeling, Oslo universitetssykehus, Ulleval og Leger Uten Grenser, 
      Postboks 8813 Youngstorget, 0028 Oslo, Norway. troseid@hotmail.com
FAU - Eskesen, Arne
AU  - Eskesen A
FAU - Bruun, Johan N
AU  - Bruun JN
LA  - nor
PT  - Case Reports
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Immunrekonstitusjonssyndrom ved behandling av hivinfeksjon.
PL  - Norway
TA  - Tidsskr Nor Laegeforen
JT  - Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny 
      raekke
JID - 0413423
RN  - 0 (Anti-Inflammatory Agents)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/diagnosis/drug therapy/microbiology
MH  - Anti-Inflammatory Agents/therapeutic use
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - HIV Infections/complications/*drug therapy/immunology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/diagnosis/drug 
      therapy/*etiology/microbiology
MH  - Prognosis
MH  - Risk Factors
RF  - 39
EDAT- 2009/12/10 06:00
MHDA- 2010/01/06 06:00
CRDT- 2009/12/10 06:00
PHST- 2009/12/10 06:00 [entrez]
PHST- 2009/12/10 06:00 [pubmed]
PHST- 2010/01/06 06:00 [medline]
AID - 1920662 [pii]
AID - 10.4045/tidsskr.09.0190 [doi]
PST - ppublish
SO  - Tidsskr Nor Laegeforen. 2009 Dec 3;129(23):2484-7. doi: 10.4045/tidsskr.09.0190.