Immune Reconstitution Inflammatory Syndrome

作者：Samuel A. Shelburne, Richard J. Hamill, Maria C. Rodriguez‐Barradas, Stephen B. Greenberg, Robert L. Atmar, Daniel M. Musher, Joseph Gathe, Fehmida Visnegarwala, Barbara Wells Trautner · 发表于：Medicine · 年份：2002 · DOI：10.1097/00005792-200205000-00005 · 被引用次数：655 · 研究领域：Infectious Diseases and Tuberculosis、Pneumocystis jirovecii pneumonia detection and treatment、Cytomegalovirus and herpesvirus research

Introduction Abbreviations used in this article: AIDS, acquired immunodeficiency syndrome, ALT, alanine aminotransferase, CMV, cytomegalovirus, CSF, cerebrospinal fluid, HAART, highly active antiretroviral therapy, HBV, hepatitis B virus, HCV, hepatitis C virus, HIV, human immunodeficiency virus, IRIS, immune reconstitution inflammatory syndrome, MAC, Mycobacterium avium complex, MTB, Mycobacterium tuberculosis, PML, progressive multifocal leukoencephalopathy The discovery of effective therapy for human immunodeficiency virus (HIV) infection has improved the outlook for patients with the acquired immunodeficiency syndrome (AIDS) (75,88,115,121,134). Since the introduction of highly active antiretroviral therapy (HAART), there has been a decrease in the incidence of opportunistic infections among HIVinfected patients along with a corresponding reduction in the mortality rate (7,30,45,102,117). The basis for these improvements appears to be a result of partial recovery of the host’s immune system. Suppression of viral replication by antiretroviral therapy allows for the reappearance of immune effector cells, that in turn, provide vital protection against opportunistic pathogens (15,32,92,95,132). However beneficial HAART has been, experience during the past several years has disclosed the emergence, in a small proportion of cases, of a unique set of complications. Soon after treatment is begun, some patients experience clinical deterioration due to restoration of their capacity...