Immune reconstitution inflammatory syndrome in HIV-infected patients

Naomi F Walker,1–3 James Scriven,2–4 Graeme Meintjes,1–3 Robert J Wilkinson1,2,5 1Department of Medicine, Imperial College London, London, UK; 2Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape...

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Autores principales:	Walker NF, Scriven J, Meintjes G, Wilkinson RJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/c7381646274a4edc92428d4cf489d75d
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spelling	oai:doaj.org-article:c7381646274a4edc92428d4cf489d75d2021-12-02T04:29:06ZImmune reconstitution inflammatory syndrome in HIV-infected patients1179-1373https://doaj.org/article/c7381646274a4edc92428d4cf489d75d2015-02-01T00:00:00Zhttp://www.dovepress.com/immune-reconstitution-inflammatory-syndrome-in-hiv-infected-patients-peer-reviewed-article-HIVhttps://doaj.org/toc/1179-1373 Naomi F Walker,1–3 James Scriven,2–4 Graeme Meintjes,1–3 Robert J Wilkinson1,2,5 1Department of Medicine, Imperial College London, London, UK; 2Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa; 3Department of Medicine, University of Cape Town, Cape Town, South Africa; 4Liverpool School of Tropical Medicine, Liverpool, UK; 5MRC National Institute of Medical Research, London, UK Abstract: Access to antiretroviral therapy (ART) is improving worldwide. Immune reconstitution inflammatory syndrome (IRIS) is a common complication of ART initiation. In this review, we provide an overview of clinical and epidemiological features of HIV-associated IRIS, current understanding of pathophysiological mechanisms, available therapy, and preventive strategies. The spectrum of HIV-associated IRIS is described, with a particular focus on three important pathogen-associated forms: tuberculosis-associated IRIS, cryptococcal IRIS, and Kaposi's sarcoma IRIS. While the clinical features and epidemiology are well described, there are major gaps in our understanding of pathophysiology and as a result therapeutic and preventative strategies are suboptimal. Timing of ART initiation is critical to reduce IRIS-associated morbidity. Improved understanding of the pathophysiology of IRIS will hopefully enable improved diagnostic modalities and better targeted treatments to be developed. Keywords: antiretroviral therapy, tuberculosis, IRIS, diagnosis, complicationsWalker NFScriven JMeintjes GWilkinson RJDove Medical PressarticleImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol 2015, Iss default, Pp 49-64 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607
spellingShingle	Immunologic diseases. Allergy RC581-607 Walker NF Scriven J Meintjes G Wilkinson RJ Immune reconstitution inflammatory syndrome in HIV-infected patients
description	Naomi F Walker,1–3 James Scriven,2–4 Graeme Meintjes,1–3 Robert J Wilkinson1,2,5 1Department of Medicine, Imperial College London, London, UK; 2Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa; 3Department of Medicine, University of Cape Town, Cape Town, South Africa; 4Liverpool School of Tropical Medicine, Liverpool, UK; 5MRC National Institute of Medical Research, London, UK Abstract: Access to antiretroviral therapy (ART) is improving worldwide. Immune reconstitution inflammatory syndrome (IRIS) is a common complication of ART initiation. In this review, we provide an overview of clinical and epidemiological features of HIV-associated IRIS, current understanding of pathophysiological mechanisms, available therapy, and preventive strategies. The spectrum of HIV-associated IRIS is described, with a particular focus on three important pathogen-associated forms: tuberculosis-associated IRIS, cryptococcal IRIS, and Kaposi's sarcoma IRIS. While the clinical features and epidemiology are well described, there are major gaps in our understanding of pathophysiology and as a result therapeutic and preventative strategies are suboptimal. Timing of ART initiation is critical to reduce IRIS-associated morbidity. Improved understanding of the pathophysiology of IRIS will hopefully enable improved diagnostic modalities and better targeted treatments to be developed. Keywords: antiretroviral therapy, tuberculosis, IRIS, diagnosis, complications
format	article
author	Walker NF Scriven J Meintjes G Wilkinson RJ
author_facet	Walker NF Scriven J Meintjes G Wilkinson RJ
author_sort	Walker NF
title	Immune reconstitution inflammatory syndrome in HIV-infected patients
title_short	Immune reconstitution inflammatory syndrome in HIV-infected patients
title_full	Immune reconstitution inflammatory syndrome in HIV-infected patients
title_fullStr	Immune reconstitution inflammatory syndrome in HIV-infected patients
title_full_unstemmed	Immune reconstitution inflammatory syndrome in HIV-infected patients
title_sort	immune reconstitution inflammatory syndrome in hiv-infected patients
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/c7381646274a4edc92428d4cf489d75d
work_keys_str_mv	AT walkernf immunereconstitutioninflammatorysyndromeinhivinfectedpatients AT scrivenj immunereconstitutioninflammatorysyndromeinhivinfectedpatients AT meintjesg immunereconstitutioninflammatorysyndromeinhivinfectedpatients AT wilkinsonrj immunereconstitutioninflammatorysyndromeinhivinfectedpatients
_version_	1718401215704858624

Immune reconstitution inflammatory syndrome in HIV-infected patients

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