PMID- 28303782
OWN - NLM
STAT- MEDLINE
DCOM- 20170705
LR  - 20180315
IS  - 2165-0497 (Electronic)
IS  - 2165-0497 (Linking)
VI  - 5
IP  - 2
DP  - 2017 Mar
TI  - Paradoxical Reactions and the Immune Reconstitution Inflammatory Syndrome.
LID - 10.1128/microbiolspec.TNMI7-0033-2016 [doi]
AB  - In HIV-infected individuals, paradoxical reactions after the initiation of 
      antiretroviral therapy (ART) are associated with a variety of underlying 
      infections and have been called the immune reconstitution inflammatory syndrome 
      (IRIS). In cases of IRIS associated with tuberculosis (TB), two distinct patterns 
      of disease are recognized: (i) the progression of subclinical TB to clinical 
      disease after the initiation of ART, referred to as unmasking, and (ii) the 
      progression or appearance of new clinical and/or radiographic disease in patients 
      with previously recognized TB after the initiation of ART, the classic or 
      "paradoxical" TB-IRIS. IRIS can potentially occur in all granulomatous diseases, 
      not just infectious ones. All granulomatous diseases are thought to result from 
      interplay of inflammatory cells and mediators. One of the inflammatory cells 
      thought to be integral to the development of the granuloma is the CD4 T 
      lymphocyte. Therefore, HIV-infected patients with noninfectious granulomatous 
      diseases such as sarcoidosis may also develop IRIS reactions. Here, we describe 
      IRIS in HIV-infected patients with TB and sarcoidosis and review the basic 
      clinical and immunological aspects of these phenomena.
FAU - Church, L W Preston
AU  - Church LWP
AD  - Ralph H. Johnson VA Medical Center, Charleston, SC 29425.
FAU - Chopra, Amit
AU  - Chopra A
AD  - Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, 
      NY 12208.
FAU - Judson, Marc A
AU  - Judson MA
AD  - Division of Pulmonary and Critical Care Medicine, Albany Medical College, Albany, 
      NY 12208.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Microbiol Spectr
JT  - Microbiology spectrum
JID - 101634614
SB  - IM
MH  - CD4-Positive T-Lymphocytes/immunology
MH  - Granuloma/pathology
MH  - HIV Infections/*complications/*drug therapy
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*etiology/*pathology
MH  - Sarcoidosis/*pathology
MH  - Tuberculosis/*pathology
EDAT- 2017/03/18 06:00
MHDA- 2017/07/06 06:00
CRDT- 2017/03/18 06:00
PHST- 2017/03/18 06:00 [entrez]
PHST- 2017/03/18 06:00 [pubmed]
PHST- 2017/07/06 06:00 [medline]
AID - 10.1128/microbiolspec.TNMI7-0033-2016 [doi]
PST - ppublish
SO  - Microbiol Spectr. 2017 Mar;5(2). doi: 10.1128/microbiolspec.TNMI7-0033-2016.