PMID- 24512544
OWN - NLM
STAT- MEDLINE
DCOM- 20141010
LR  - 20140219
IS  - 1744-764X (Electronic)
IS  - 1474-0338 (Linking)
VI  - 13
IP  - 3
DP  - 2014 Mar
TI  - Immune reconstitution inflammatory syndrome associated with bacterial infections.
PG  - 341-50
LID - 10.1517/14740338.2014.887677 [doi]
AB  - INTRODUCTION: Immune reconstitution inflammatory syndrome (IRIS) is defined by 
      various clinical manifestations following the initiation of antiretroviral 
      treatment (ART) in HIV patients primarily infected with Mycobacteria. IRIS has 
      clinical similarities with lepromatous reactions in patients with leprosy 
      following antibiotic initiation. AREAS COVERED: Tuberculosis and more rarely 
      lepromatous leprae and Whipple's disease are the main diseases caused by 
      actinobacteria associated with IRIS, regardless of HIV status. The pathogenesis 
      of this syndrome remains complex and partially understood. The treatment for IRIS 
      is non-evidence-based, except for corticosteroids in tuberculosis-IRIS. 
      Thalidomide and other immunomodulatory drugs have been successfully used in case 
      series. EXPERT OPINION: IRIS is mainly observed during infections (viral, fungal 
      or bacterial) which involve inefficient macrophages for the clearance of 
      bacteria, namely Actinobacteria such as Mycobacterium leprae, M. tuberculosis and 
      Tropheryma whipplei. The restoration of macrophage competence after ART or 
      antibiotic initiation results from a complex mechanism, probably involving a 
      sudden and violent immune reaction with a cytokine storm, such as TNF-alpha and 
      IFN-gamma. This overreaction might be controlled using corticosteroids and 
      thalidomide.
FAU - Lagier, Jean-Christophe
AU  - Lagier JC
AD  - Aix-Marseille Universite, URMITE, UM63, CNRS 7278, IRD 198, INSERM 1095, Faculte 
      de Medecine , 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France.
FAU - Raoult, Didier
AU  - Raoult D
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20140210
PL  - England
TA  - Expert Opin Drug Saf
JT  - Expert opinion on drug safety
JID - 101163027
RN  - 0 (Anti-Retroviral Agents)
SB  - IM
MH  - Anti-Retroviral Agents/*adverse effects/therapeutic use
MH  - Bacterial Infections/drug therapy
MH  - HIV Infections/drug therapy
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*drug therapy/etiology
EDAT- 2014/02/12 06:00
MHDA- 2014/10/11 06:00
CRDT- 2014/02/12 06:00
PHST- 2014/02/12 06:00 [entrez]
PHST- 2014/02/12 06:00 [pubmed]
PHST- 2014/10/11 06:00 [medline]
AID - 10.1517/14740338.2014.887677 [doi]
PST - ppublish
SO  - Expert Opin Drug Saf. 2014 Mar;13(3):341-50. doi: 10.1517/14740338.2014.887677. 
      Epub 2014 Feb 10.