PMID- 22752438
OWN - NLM
STAT- MEDLINE
DCOM- 20121119
LR  - 20211021
IS  - 1548-3576 (Electronic)
IS  - 1548-3568 (Linking)
VI  - 9
IP  - 3
DP  - 2012 Sep
TI  - Management of the immune reconstitution inflammatory syndrome.
PG  - 238-50
LID - 10.1007/s11904-012-0129-5 [doi]
AB  - The immune reconstitution inflammatory syndrome (IRIS) is a frequent early 
      complication of antiretroviral therapy (ART) in patients with advanced HIV. 
      Because there is no confirmatory diagnostic test, the diagnosis is based on 
      clinical presentation and exclusion of alternative causes for deterioration, such 
      as antimicrobial drug resistance. Opportunistic infection treatment should be 
      optimized. Mild cases may require symptomatic therapy alone or nonsteroidal 
      anti-inflammatory drugs. Corticosteroids have been used to treat more severe 
      cases of IRIS associated with mycobacterial and fungal infections. There is 
      evidence from a randomized controlled trial that prednisone reduces morbidity and 
      improves symptoms in paradoxical tuberculosis (TB)-IRIS. Neurological TB-IRIS is 
      potentially life-threatening; high-dose corticosteroids are indicated and ART 
      interruption should be considered if level of consciousness is depressed. When 
      considering corticosteroid treatment clinicians should be aware of their side 
      effects and only use them when the diagnosis of IRIS is certain. In viral forms 
      of IRIS corticosteroids are generally avoided.
FAU - Meintjes, Graeme
AU  - Meintjes G
AD  - Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, 
      Cape Town, South Africa. graemein@mweb.co.za
FAU - Scriven, James
AU  - Scriven J
FAU - Marais, Suzaan
AU  - Marais S
LA  - eng
GR  - 1U2RTW007370/PHS HHS/United States
GR  - 1U2RTW007373-01A1/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 HIV/AIDS Rep
JT  - Current HIV/AIDS reports
JID - 101235661
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*drug therapy/immunology
MH  - Acquired Immunodeficiency Syndrome/*drug therapy/immunology
MH  - Adrenal Cortex Hormones/administration & dosage
MH  - Anti-HIV Agents/administration & dosage/*adverse effects
MH  - Anti-Inflammatory Agents, Non-Steroidal/administration & dosage
MH  - Female
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/chemically induced/*drug 
      therapy/*etiology/virology
MH  - Male
MH  - Mycobacterium Infections/*drug therapy/immunology
MH  - Tuberculosis/*drug therapy/immunology
EDAT- 2012/07/04 06:00
MHDA- 2012/12/10 06:00
CRDT- 2012/07/04 06:00
PHST- 2012/07/04 06:00 [entrez]
PHST- 2012/07/04 06:00 [pubmed]
PHST- 2012/12/10 06:00 [medline]
AID - 10.1007/s11904-012-0129-5 [doi]
PST - ppublish
SO  - Curr HIV/AIDS Rep. 2012 Sep;9(3):238-50. doi: 10.1007/s11904-012-0129-5.