PMID- 20146693
OWN - NLM
STAT- MEDLINE
DCOM- 20100325
LR  - 20100211
IS  - 1749-6632 (Electronic)
IS  - 0077-8923 (Linking)
VI  - 1184
DP  - 2010 Jan
TI  - Neurological complications of immune reconstitution in HIV-infected populations.
PG  - 106-20
LID - 10.1111/j.1749-6632.2009.05111.x [doi]
AB  - The introduction of highly active antiretroviral therapy (HAART) for human 
      immunodeficiency virus (HIV) infection has transformed this disease from a fatal 
      infection to a chronic yet manageable condition by restoring immune function. All 
      the same, this restoration of immune response in some may be associated with 
      deterioration in clinical status, which has been termed immune reconstitution 
      inflammatory syndrome (IRIS). This syndrome often occurs in the context of an 
      underlying opportunistic infection and develops after an interval of weeks to 
      months after the initiation of HAART. Occasionally, IRIS may occur in the brain 
      without any opportunistic infection, which presents as a T cell-mediated 
      encephalitis. This paradoxical infiltration of previously immune suppressed 
      patients with T cells represents a diagnostic challenge and a treatment dilemma. 
      Nonetheless, CNS-IRIS with or without an opportunistic infection can range in 
      severity. Severe cases can be fatal and hence require intervention with steroid 
      treatment. This review discusses the diagnosis, clinical manifestations, risk 
      factors, pathophysiology, and potential treatment strategies of the various forms 
      of IRIS that involve the nervous system.
FAU - Johnson, Tory
AU  - Johnson T
AD  - Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA.
FAU - Nath, Avindra
AU  - Nath A
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Review
PL  - United States
TA  - Ann N Y Acad Sci
JT  - Annals of the New York Academy of Sciences
JID - 7506858
SB  - IM
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Brain/drug effects/immunology/pathology
MH  - Central Nervous System/immunology
MH  - Diagnosis, Differential
MH  - HIV Infections/complications/drug therapy/*immunology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/epidemiology/*etiology
MH  - Magnetic Resonance Imaging
MH  - Opportunistic Infections/epidemiology
MH  - Risk Factors
MH  - T-Lymphocytes/immunology
RF  - 114
EDAT- 2010/02/12 06:00
MHDA- 2010/03/26 06:00
CRDT- 2010/02/12 06:00
PHST- 2010/02/12 06:00 [entrez]
PHST- 2010/02/12 06:00 [pubmed]
PHST- 2010/03/26 06:00 [medline]
AID - NYAS5111 [pii]
AID - 10.1111/j.1749-6632.2009.05111.x [doi]
PST - ppublish
SO  - Ann N Y Acad Sci. 2010 Jan;1184:106-20. doi: 10.1111/j.1749-6632.2009.05111.x.