PMID- 26720550
OWN - NLM
STAT- MEDLINE
DCOM- 20161026
LR  - 20220408
IS  - 1746-6318 (Electronic)
IS  - 1746-630X (Print)
IS  - 1746-630X (Linking)
VI  - 11
IP  - 2
DP  - 2016 Mar
TI  - HIV infection and immune activation: the role of coinfections.
PG  - 191-200
LID - 10.1097/COH.0000000000000241 [doi]
AB  - PURPOSE OF REVIEW: This article explores new data from recent studies addressing 
      the role of coinfections in immune activation in HIV-1-infected patients, with a 
      focus on immune reconstitution inflammatory syndrome (IRIS), an aberrant 
      inflammatory response occurring shortly after antiretroviral therapy (ART) 
      initiation. RECENT FINDINGS: Chronic HIV infection is associated with several 
      coinfections that contribute to immune activation in various settings including 
      early after ART initiation in the most noticeable form of IRIS and also in 
      chronic-treated infection, with chronic viral infections like cytomegalovirus and 
      hepatitis C or hepatitis B virus contributing to immune activation and also 
      morbidity and mortality. Expanding on older studies, the role of T cells in IRIS 
      has been further elucidated with evidence of more pronounced effector activity in 
      patients with IRIS that may be leading to excessive tissue disorder. Newer 
      studies are also continuing to shed light on the role of myeloid cells as well as 
      the contribution of antigen load in IRIS. In addition, preliminary data are 
      beginning to suggest a possible role of inflammasome formation in IRIS. In 
      cryptococcal IRIS, the role of activated immune cells (T cell and myeloid) and 
      biomarkers were evaluated in more detail at the site of infection (cerebrospinal 
      fluid). Finally, important differences of patients developing IRIS versus those 
      who die from tuberculosis despite ART initiation were reported, a distinction 
      that may have important implications for participant selection in studies aiming 
      to prevent IRIS with immunosuppressive agents. SUMMARY: Better understanding of 
      the role of opportunistic infections at ART initiation and IRIS pathogenesis will 
      assist in improved strategies for prevention and treatment. The long-term 
      consequences of IRIS remain unclear. Chronic viral coinfections with 
      herpesviruses and hepatitis C virus are important factors in persistent immune 
      activation in chronic-treated HIV.
FAU - Boulougoura, Afroditi
AU  - Boulougoura A
AD  - HIV Pathogenesis Section, Laboratory of Immunoregulation, National Institute of 
      Allergy and Infectious Diseases, National Institutes of Health, Bethesda, 
      Maryland, USA.
FAU - Sereti, Irini
AU  - Sereti I
LA  - eng
GR  - Z99 AI999999/Intramural NIH HHS/United States
GR  - ZIA AI001121-01/Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Intramural
PT  - Review
PL  - United States
TA  - Curr Opin HIV AIDS
JT  - Current opinion in HIV and AIDS
JID - 101264945
RN  - 0 (Biomarkers)
SB  - IM
MH  - Biomarkers
MH  - *Coinfection
MH  - *HIV Infections/complications/immunology/physiopathology
MH  - Humans
MH  - *Immune Reconstitution Inflammatory 
      Syndrome/complications/immunology/physiopathology
MH  - Immunity, Innate
PMC - PMC4831133
MID - NIHMS755181
COIS- Conflicts of interest. The authors have no conflicts of interest to declare.
EDAT- 2016/01/01 06:00
MHDA- 2016/10/27 06:00
PMCR- 2017/03/01
CRDT- 2016/01/01 06:00
PHST- 2017/03/01 00:00 [pmc-release]
PHST- 2016/01/01 06:00 [entrez]
PHST- 2016/01/01 06:00 [pubmed]
PHST- 2016/10/27 06:00 [medline]
AID - 10.1097/COH.0000000000000241 [doi]
PST - ppublish
SO  - Curr Opin HIV AIDS. 2016 Mar;11(2):191-200. doi: 10.1097/COH.0000000000000241.