Predicting Immune Reconstitution Syndrome

Clinical Infectious Diseases (Impact Factor: 8.89). 02/2007; 44(1):147-8; author reply 148-9. DOI: 10.1086/509642
Source: PubMed
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    ABSTRACT: An estimated 40 million people live with human immunodeficiency virus (HIV) globally, and over four million people were newly diagnosed with HIV infection in 2006. Twenty-five million people have died as a result of HIV since its recognition in 1981. Where available, highly active antiretroviral therapy has resulted in significant decreases in HIV-associated morbidity and mortality. Nevertheless, opportunistic infections and conditions continue to occur, and their recognition and management continue to be an important component of HIV care.
    International Journal of Dermatology 01/2008; 46(12):1219-28. DOI:10.1111/j.1365-4632.2007.03520.x · 1.31 Impact Factor
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    ABSTRACT: It has now been some 25 years since the initial description of AIDS. Following these observations, the epidemiology, natural history and manifestations of this disease have been well characterised. Intense investigation has better characterised HIV, resulting in the development of effective drug therapies to arrest disease progression. These multidrug combinations, termed highly active antiretroviral therapy or HAART, can suppress the viral load to the undetectable range and secondarily halt the destruction of CD4 T lymphocytes. This virological response is associated with a marked improvement in survival and absence of the many complications related to immunodeficiency. For patients who respond to HAART, the current emphasis is on treating side effects from the medications as well as treating other non-AIDS-related disorders. However, given the cost and complexities of these regimens, there are many patients who continue to present with the classic manifestations of AIDS, and, especially in the developing world, we will continue to see these patients for years to come.
    Gut 07/2008; 57(6):861-70. DOI:10.1136/gut.2006.103432 · 14.66 Impact Factor
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    ABSTRACT: HIV and tuberculosis (TB) are leading global causes of mortality and morbidity. Highly active antiretroviral therapy (HAART) is often initiated in patients being treated for TB. The immune recovery associated with HAART results in dramatic clinical benefits, but this restoration of immunity may result in immunopathological reactions. The immune reconstitution inflammatory syndrome can result in fever, nodal enlargement, and worsening pulmonary infiltrates observed on a chest radiograph, with or without recurrent respiratory symptoms. Several other manifestations have also been described. As a consequence, the use of HAART might not be appropriate during the first weeks of anti-TB therapy in HIV-infected patients. In this review, we summarize the incidence, clinical presentations, and potential mechanisms of these conditions and we describe therapeutic methods.
    International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 09/2009; 14(4):e283-91. DOI:10.1016/j.ijid.2009.05.016 · 1.86 Impact Factor
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