PMID- 22233655
OWN - NLM
STAT- MEDLINE
DCOM- 20120627
LR  - 20220410
IS  - 1473-5571 (Electronic)
IS  - 0269-9370 (Print)
IS  - 0269-9370 (Linking)
VI  - 26
IP  - 6
DP  - 2012 Mar 27
TI  - Immune reconstitution inflammatory syndrome: incidence and implications for 
      mortality.
PG  - 721-30
LID - 10.1097/QAD.0b013e3283511e91 [doi]
AB  - OBJECTIVE: To describe incidence of immune reconstitution inflammatory syndrome 
      (IRIS) and its association with mortality in a large multisite US HIV-infected 
      cohort applying an objective, comprehensive definition. DESIGN: We studied 2,610 
      patients seen during 1996-2007 who initiated or resumed highly active combination 
      antiretroviral therapy (cART) and, during the next 6 months, demonstrated a 
      decline in plasma HIV-RNA viral load of at least 0.5 log(10) copies/ml or an 
      increase of at least 50% in CD4 cell count per microliter. We defined IRIS as the 
      diagnosis of a type B or C condition [as per the Centers for Disease Control and 
      Prevention (CDC) 1993 AIDS case definition] or any new mucocutaneous disorder 
      during this same 6-month period. METHODS: We assessed the incidence of IRIS and 
      evaluated risk factors for IRIS using conditional logistic regression and for 
      all-cause mortality using proportional hazards models. RESULTS: We identified 370 
      cases of IRIS (in 276 patients). Median and nadir CD4 cell counts at cART 
      initiation were 90 and 43 cells/mul, respectively; median viral load was 2.7 
      log(10) copies/ml. The most common IRIS-defining diagnoses were candidiasis (all 
      forms), cytomegalovirus infection, disseminated Mycobacterium avium 
      intracellulare, Pneumocystis pneumonia, varicella zoster, Kaposi's sarcoma and 
      non-Hodgkin lymphoma. Only one case of Mycobacterium tuberculosis was observed. 
      IRIS was independently associated with CD4 cell count less than 50 cells/mul vs. 
      at least 200 cells/mul [odds ratio (OR) 5.0] and a viral load of at least 5.0 
      log(10) copies vs. less than 4.0 log(10) copies (OR 2.3). IRIS with a type 
      B-defining or type C-defining diagnosis approximately doubled the risk for 
      all-cause mortality. CONCLUSION: In this large US-based HIV-infected cohort, IRIS 
      occurred in 10.6% of patients who responded to effective ART and contributed to 
      increased mortality.
FAU - Novak, Richard M
AU  - Novak RM
AD  - University of Illinois, Chicago, 60612, USA. rmnovak@uic.edu
FAU - Richardson, James T
AU  - Richardson JT
FAU - Buchacz, Kate
AU  - Buchacz K
FAU - Chmiel, Joan S
AU  - Chmiel JS
FAU - Durham, Marcus D
AU  - Durham MD
FAU - Palella, Frank J
AU  - Palella FJ
FAU - Wendrow, Andrea
AU  - Wendrow A
FAU - Wood, Kathy
AU  - Wood K
FAU - Young, Benjamin
AU  - Young B
FAU - Brooks, John T
AU  - Brooks JT
CN  - HIV Outpatient Study (HOPS) Investigators
LA  - eng
GR  - CC999999/ImCDC/Intramural CDC HHS/United States
GR  - 200-2001-00133/PHS HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - England
TA  - AIDS
JT  - AIDS (London, England)
JID - 8710219
RN  - 0 (RNA, Viral)
SB  - IM
CIN - Expert Rev Anti Infect Ther. 2012 Jul;10(7):737-41. PMID: 22943397
MH  - Adolescent
MH  - Adult
MH  - Antiretroviral Therapy, Highly Active/*mortality
MH  - Bacterial Infections/*mortality
MH  - CD4 Lymphocyte Count
MH  - Female
MH  - HIV Infections/drug therapy/immunology/*mortality
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*mortality
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - RNA, Viral
MH  - Risk Factors
MH  - United States/epidemiology
MH  - Viral Load
MH  - Young Adult
PMC - PMC4657750
MID - NIHMS736795
OID - NLM: HHSPA736795
FIR - Brooks, John T
IR  - Brooks JT
FIR - Buchacz, Kate
IR  - Buchacz K
FIR - Durham, Marcus D
IR  - Durham MD
FIR - W, K C
IR  - W KC
FIR - Baker, Rose K
IR  - Baker RK
FIR - Richardson, James T
IR  - Richardson JT
FIR - Hankerson, Darlene
IR  - Hankerson D
FIR - Armon, Carl
IR  - Armon C
FIR - Palella, Frank J
IR  - Palella FJ
FIR - Chmiel, Joan S
IR  - Chmiel JS
FIR - Studney, Carolyn
IR  - Studney C
FIR - Enyia, Onyinye
IR  - Enyia O
FIR - Lichtenstein, Kenneth A
IR  - Lichtenstein KA
FIR - Stewart, Cheryl
IR  - Stewart C
FIR - Hammer, John
IR  - Hammer J
FIR - Young, Benjamin
IR  - Young B
FIR - Greenberg, Kenneth S
IR  - Greenberg KS
FIR - Widick, Barbara
IR  - Widick B
FIR - Axinn, Joslyn D
IR  - Axinn JD
FIR - Yangco, Bienvenido G
IR  - Yangco BG
FIR - Halkias, Kalliope
IR  - Halkias K
FIR - Ward, Douglas J
IR  - Ward DJ
FIR - Miller, Jay
IR  - Miller J
FIR - Fuhrer, Jack
IR  - Fuhrer J
FIR - Ording-Bauer, Linda
IR  - Ording-Bauer L
FIR - Kelly, Rita
IR  - Kelly R
FIR - Esteves, Jane
IR  - Esteves J
FIR - Tedaldi, Ellen M
IR  - Tedaldi EM
FIR - Christian, Ramona A
IR  - Christian RA
FIR - Ruley, Faye
IR  - Ruley F
FIR - Beadle, Dania
IR  - Beadle D
FIR - Novak, Richard M
IR  - Novak RM
FIR - Wendrow, Andrea
IR  - Wendrow A
EDAT- 2012/01/12 06:00
MHDA- 2012/06/28 06:00
PMCR- 2015/11/24
CRDT- 2012/01/12 06:00
PHST- 2012/01/12 06:00 [entrez]
PHST- 2012/01/12 06:00 [pubmed]
PHST- 2012/06/28 06:00 [medline]
PHST- 2015/11/24 00:00 [pmc-release]
AID - 10.1097/QAD.0b013e3283511e91 [doi]
PST - ppublish
SO  - AIDS. 2012 Mar 27;26(6):721-30. doi: 10.1097/QAD.0b013e3283511e91.