Tuberculosis-immune reconstitution inflammatory syndrome.
Tuberculosis-immune reconstitution inflammatory syndrome.
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DOI：
10.1016/j.jctube.2016.03.002
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发表时间：
2016-05-01
影响因子：
2
通讯作者：
Vento, Sandro
中科院分区：
文献类型：
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作者：
Lanzafame, Massimiliano;Vento, Sandro
结核病-免疫重建炎症综合征是一种针对结核分枝杆菌的过度免疫反应，可发生在HIV感染或未感染的患者中，在抗结核治疗期间或完成后。在HIV感染患者中，它发生在开始抗逆转录病毒治疗后，与HIV病毒血症的有效抑制无关。IRIS有两种形式：矛盾的或揭露的。副反应性IRIS的特点是复发，新的，或恶化的症状治疗的情况下。暴露IRIS是一种抗逆转录病毒相关的炎症表现的亚临床感染，具有加速的表现。发病机制尚未完全了解，流行病学部分描述。没有特定的测试可以建立或排除诊断。治疗是基于抗结核药物的使用，有时与皮质类固醇激素。死亡率一般较低。
Tuberculosis-immune reconstitution inflammatory syndrome is an excessive immune response against Mycobacterium tuberculosis that may occur in either HIV-infected or uninfected patients, during or after completion of anti-TB therapy. In HIV-infected patients it occurs after initiation of antiretroviral therapy independently from an effective suppression of HIV viremia. There are two forms of IRIS: paradoxical or unmasking. Paradoxical IRIS is characterized by recurrent, new, or worsening symptoms of a treated case. Unmasking IRIS is an antiretroviral-associated inflammatory manifestation of a subclinical infection with a hastened presentation. The pathogenesis is incompletely understood and the epidemiology partially described. No specific tests can establish or rule out the diagnosis. Treatment is based on the use of anti-tuberculosis drugs sometime with adjunctive corticosteroids. Mortality is generally low.