Article

Update on immune reconstitution inflammatory syndrome: progress and unanswered questions.

Division of Infectious Disease, Department of Medicine, Emory University School of Medicine, 341 Ponce de Leon Avenue, Atlanta, GA 30308, USA.
Current Infectious Disease Reports 11/2009; 11(6):486-93.
Source: PubMed

ABSTRACT The immune reconstitution inflammatory syndrome (IRIS) is characterized by clinical deterioration occurring after the initiation of effective antiretroviral therapy (ART) and results from a disordered and exuberant immune response. The syndrome may present as paradoxical IRIS or unmasking IRIS, depending on whether an opportunistic infection was recognized and treated before ART initiation. Numerous descriptions of IRIS caused by many pathogens were published in the years after the introduction of effective ART. In recent years, with enhanced rollout of ART in resource-limited settings, attention has again focused on IRIS because of the enormous burden of opportunistic infections. This review highlights recent findings elucidating risk factors for and the pathogenesis and treatment of IRIS.

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Keywords

ART initiation
 
clinical deterioration
 
disordered
 
effective antiretroviral therapy
 
effective ART
 
exuberant immune response
 
immune reconstitution inflammatory syndrome
 
initiation
 
IRIS
 
opportunistic infections
 
paradoxical IRIS
 
recent findings elucidating risk factors
 
recent years
 
resource-limited settings
 
rollout
 
unmasking IRIS