PMID- 21346572
OWN - NLM
STAT- MEDLINE
DCOM- 20110719
LR  - 20131121
IS  - 1531-6971 (Electronic)
IS  - 1070-5287 (Linking)
VI  - 17
IP  - 3
DP  - 2011 May
TI  - Pulmonary manifestations of the immune reconstitution inflammatory syndrome.
PG  - 180-8
LID - 10.1097/MCP.0b013e328344f692 [doi]
AB  - PURPOSE OF REVIEW: Immune reconstitution inflammatory syndrome (IRIS) is a common 
      occurrence in HIV patients starting antiretroviral therapy (ART), and pulmonary 
      involvement is an important feature of tuberculosis-IRIS and pneumocystis-IRIS. 
      Pulmonologists need an awareness of the timing, presentation and treatment of 
      pulmonary IRIS. RECENT FINDINGS: Case definitions for tuberculosis-IRIS and 
      cryptococcal-IRIS have been published by the International Network for the Study 
      of HIV-associated IRIS (INSHI). A number of studies have addressed validation of 
      clinical case definitions and the optimal time to commence ART after diagnosis of 
      an opportunistic infection in HIV patients. The pathogenesis of IRIS is being 
      assessed at a molecular level, increasing our understanding of mechanisms and 
      possible targets for future preventive and therapeutic strategies. SUMMARY: 
      Tuberculosis-IRIS, nontuberculosis mycobacterial-IRIS and pneumocystis-IRIS occur 
      within days to weeks of starting ART, causing substantial morbidity, but low 
      mortality. Cryptococcal-IRIS usually occurs later in the course of ART, and may 
      be associated with appreciable mortality. Early recognition of unmasking and 
      paradoxical IRIS affecting the lung allows timely initiation of antimicrobial 
      and/or immunomodulatory therapies.
FAU - Calligaro, Gregory
AU  - Calligaro G
AD  - Division of Pulmonology, Department of Medicine, University of Cape Town, Groote 
      Schuur Hospital, Cape Town, South Africa.
FAU - Meintjes, Graeme
AU  - Meintjes G
FAU - Mendelson, Marc
AU  - Mendelson M
LA  - eng
GR  - U2RTW007370-01A1/PHS HHS/United States
GR  - U2RTW007373-01A1/PHS HHS/United States
GR  - Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Curr Opin Pulm Med
JT  - Current opinion in pulmonary medicine
JID - 9503765
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (Glucocorticoids)
RN  - VB0R961HZT (Prednisone)
SB  - IM
MH  - Anti-Retroviral Agents/adverse effects/therapeutic use
MH  - Glucocorticoids/therapeutic use
MH  - HIV Infections/drug therapy
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*complications
MH  - Pneumocystis Infections/drug therapy/epidemiology/*etiology
MH  - Prednisone/therapeutic use
MH  - Risk Factors
MH  - Tuberculosis/drug therapy/epidemiology/*etiology
EDAT- 2011/02/25 06:00
MHDA- 2011/07/20 06:00
CRDT- 2011/02/25 06:00
PHST- 2011/02/25 06:00 [entrez]
PHST- 2011/02/25 06:00 [pubmed]
PHST- 2011/07/20 06:00 [medline]
AID - 10.1097/MCP.0b013e328344f692 [doi]
PST - ppublish
SO  - Curr Opin Pulm Med. 2011 May;17(3):180-8. doi: 10.1097/MCP.0b013e328344f692.