Immune reconstitution inflammatory syndrome: more answers, more questions
Immune reconstitution inflammatory syndrome: more answers, more questions
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DOI：
10.1093/jac/dki444
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发表时间：
2006-02-01
影响因子：
5.2
通讯作者：
Hamill, RJ
中科院分区：
文献类型：
--
作者：
Shelburne, SA;Montes, M;Hamill, RJ
在艾滋病毒感染患者中采用高效抗逆转录病毒疗法（HAART）可恢复针对多种病原体的保护性免疫反应，并显著降低死亡率。在接受HAART治疗的一部分患者中，免疫重建与病理性炎症反应相关，导致大量短期发病率甚至死亡率。在过去的几年中，我们对免疫重建炎症综合征（IRIS）的临床认识取得了显著进展，但仍存在许多问题。本文综述了IRIS发展的临床危险因素的最新数据。来自多个小组的一致发现是，在有潜在机会性感染并接受HAART治疗的艾滋病毒感染患者中发生IRIS的比例相当大。由于HAART的使用在未来几年将显著增加，接受HAART的患者的最佳护理将需要包括IRIS并发症的监测和治疗。
The institution of highly active antiretroviral therapy (HAART) in HIV-infected patients restores protective immune responses against a wide variety of pathogens and dramatically decreases mortality. In a subset of patients receiving HAART, immune reconstitution is associated with a pathological inflammatory response leading to substantial short-term morbidity and even mortality. The past several years have seen marked advances in our clinical understanding of the immune reconstitution inflammatory syndrome (IRIS), but many questions remain. This article summarizes recent data on clinical risk factors for the development of IRIS. A consistent finding from multiple groups is that IRIS develops in a substantial percentage of HIV-infected patients who have an underlying opportunistic infection and receive HAART. As the use of HAART stands to markedly increase over the next several years, optimal care of patients receiving HAART will need to incorporate monitoring for and treating complications of IRIS.