PMID- 29173177
OWN - NLM
STAT- MEDLINE
DCOM- 20190411
LR  - 20190411
IS  - 1873-4251 (Electronic)
IS  - 1570-162X (Linking)
VI  - 15
IP  - 6
DP  - 2017
TI  - Integrase Strand Transfer Inhibitors and the Emergence of Immune Reconstitution 
      Inflammatory Syndrome (IRIS).
PG  - 405-410
LID - 10.2174/1570162X15666171122155708 [doi]
AB  - BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) is a major concern 
      when starting highly active anti-retroviral therapy (HAART) in new patients and 
      especially late presenters. This study attempts to identify risk factors for IRIS 
      and investigate whether certain treatment regimens increase the probability of 
      IRIS for patients at risk. METHODS: Retrospective single-centre study of HIV 
      patients treated with HAART. RESULTS: A total of 417 patients were included. We 
      identified 45 cases of IRIS in 37 patients; an incidence of 13.3 cases over 1000 
      person-years. In univariate analysis, IRIS development was significantly 
      associated with CDC stage, the presence of an opportunistic infection (OI) at 
      diagnosis, CD4 cell count and viral load at diagnosis and HAART initiation and 
      the use of integrase strand inhibitors (INSTIs). In multivariate analysis, INSTIs 
      use (OR 2.89; 95%CI 1.26-6.64; p=0.012), CD4</=200/mm3 (OR 5.56; 95%CI 2.2-13.98; 
      p<0.001), and the presence of an OI (OR 4.74; 95%CI 2.13-10.23; p=0.012) were 
      independent risk factors. Among INSTI regimens, dolutegravir (OR 4.99 vs. NNRTI; 
      95%CI 1.11-22.55; p=0.037) and elvitegravir (OR 4.82 vs. NNRTI; 95%CI 1.43-16.19; 
      p=0.011) seem to carry increased risk. Mortality was 18.9% (7/37) for IRIS 
      patients compared to 9.7% (37/380) in the non-IRIS group. Mortality at any given 
      time during follow-up was significantly higher in the IRIS group (HR 3.2; 95%CI 
      1.39-7.36; p=0.006). CONCLUSION: The use of INSTIs and especially DTG and EVG is 
      associated with a higher probability for the development of IRIS in the 
      background of late presentation and the presence of OIs. These data highlight the 
      need for further research.
CI  - Copyright(c) Bentham Science Publishers; For any queries, please email at 
      epub@benthamscience.org.
FAU - Psichogiou, Mina
AU  - Psichogiou M
AD  - 1st Internal Medicine Department, Laiko General Hospital, National and 
      Kapodistrian University of Athens, Greece.
FAU - Basoulis, Dimitrios
AU  - Basoulis D
AD  - 1st Internal Medicine Department, Laiko General Hospital, National and 
      Kapodistrian University of Athens, Greece.
FAU - Tsikala-Vafea, Maria
AU  - Tsikala-Vafea M
AD  - 1st Internal Medicine Department, Laiko General Hospital, National and 
      Kapodistrian University of Athens, Greece.
FAU - Vlachos, Stefanos
AU  - Vlachos S
AD  - 1st Internal Medicine Department, Laiko General Hospital, National and 
      Kapodistrian University of Athens, Greece.
FAU - Kapelios, Christos J
AU  - Kapelios CJ
AD  - Cardiology Department, Laiko General Hospital, Athens, Greece.
FAU - Daikos, Georgios L
AU  - Daikos GL
AD  - 1st Internal Medicine Department, Laiko General Hospital, National and 
      Kapodistrian University of Athens, Greece.
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Curr HIV Res
JT  - Current HIV research
JID - 101156990
RN  - 0 (Reverse Transcriptase Inhibitors)
SB  - IM
MH  - Adult
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Comorbidity
MH  - *Disease Susceptibility
MH  - Female
MH  - Follow-Up Studies
MH  - HIV Infections/*complications/drug therapy/*epidemiology/virology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/diagnosis/*epidemiology/*etiology
MH  - Male
MH  - Middle Aged
MH  - Mortality
MH  - Odds Ratio
MH  - Retrospective Studies
MH  - Reverse Transcriptase Inhibitors/*adverse effects/therapeutic use
MH  - Risk Assessment
MH  - Risk Factors
MH  - Young Adult
OTO - NOTNLM
OT  - HAART
OT  - HIV
OT  - immune reconstitution inflammatory syndrome
OT  - integrase strand transfer inhibitors
OT  - late presenters
EDAT- 2017/11/28 06:00
MHDA- 2019/04/12 06:00
CRDT- 2017/11/28 06:00
PHST- 2017/09/09 00:00 [received]
PHST- 2017/09/25 00:00 [revised]
PHST- 2017/10/05 00:00 [accepted]
PHST- 2017/11/28 06:00 [pubmed]
PHST- 2019/04/12 06:00 [medline]
PHST- 2017/11/28 06:00 [entrez]
AID - CHR-EPUB-87064 [pii]
AID - 10.2174/1570162X15666171122155708 [doi]
PST - ppublish
SO  - Curr HIV Res. 2017;15(6):405-410. doi: 10.2174/1570162X15666171122155708.