Year: 2015
Type: article
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.
DOI: 10.2147/hiv.s42328
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,320
Awards: G1460800348, Quadruple intervention against tuberculosis., G2006052962, G2120397826, Defining interventions to reduce mortality in severe HIV-associated tuberculosis., G3713413865, G374283917, Host directed therapies against tuberculosis., European and South African HIV co-infection research consortium, Wellcome Trust-Liverpool-Glasgow Trust Centre for Global Health Research, G5719191341, Host directed therapies against tuberculosis., G5858598186, Defining mechanisms driving immunopathology in Tuberculosis-HIV Co-infection., Pathogen COinfection:
HIV, Tuberculosis, Malaria and Hepatitis C virus, G6346810159, Wellcome Trust Clinical PhD Programme at the University of Liverpool., G7042805398, G7658311513, G76681233, Establishment of a Centre for Clinical Infectious Diseases Research at the University of Cape Town (Wellcome-UCT-CCIDR).
OpenAlex ID: W2076838573