Incidence and risk factors for immune reconstitution inflammatory syndrome during highly active antiretroviral therapy
Incidence and risk factors for immune reconstitution inflammatory syndrome during highly active antiretroviral therapy
复制标题
DOI：
10.1097/01.aids.0000161769.06158.8a
复制
发表时间：
2005-03-04
期刊：
影响因子：
3.8
通讯作者：
Hamill, RJ
中科院分区：
文献类型：
--
作者：
Shelburne, SA;Visnegarwala, F;Hamill, RJ
背景资料：免疫重建炎症综合征（IRIS）的系统信息很少。目的：探讨接受高效抗逆转录病毒治疗（HAART）的HIV感染患者合并感染三种常见机会致病菌之一后发生IRIS的发病率、危险因素和长期预后。设计图：一个回顾性队列确定通过全市范围内的前瞻性surveillance programmes.Methods：一个回顾性的图表审查进行了180艾滋病病毒感染的患者接受HAART和合并感染结核分枝杆菌，鸟分枝杆菌复合体，或新型隐球菌在1997年和2000年之间。医疗记录进行了审查的基线人口统计学，接收和类型的HAART，抗逆转录病毒治疗的反应，IRIS的发展，和长期outcome.Results：在这个队列中，31.7%的患者接受HAART开发IRIS。IRIS患者更有可能在接近机会性感染诊断的时间开始HAART治疗（P < 0.001），在诊断机会性感染时未接受过抗逆转录病毒治疗（P < 0.001），HAART治疗后HIV-1 RNA水平下降更快结论：HIV感染者合并M. tuberculosis，M. avium complex或C.新人类对于在机会性感染确诊前开始HAART治疗且HIV-1 RNA水平迅速下降的抗逆转录病毒药物初治患者，应监测其是否发生这种疾病。(c)2005年利平科特威廉姆斯&威尔金斯。
Background: There is little systematic information regarding the immune reconstitution inflammatory syndrome (IRIS).Objective: To determine the incidence, risk factors, and long-term outcome of IRIS in HIV-infected patients receiving highly active antiretroviral therapy (HAART) who were coinfected with one of three common opportunistic pathogens. Design: A retrospective cohort identified through a city-wide prospective surveillance program.Methods: A retrospective chart review was performed for 180 HIV-infected patients who received HAART and were coinfected with Mycobacterium tuberculosis, Mycobacterium avium complex, or Cryptococcus neoformans between 1997 and 2000. Medical records were reviewed for baseline demographics, receipt and type of HAART, response to antiretroviral therapy, development of IRIS, and long-term outcome.Results: In this cohort, 31.7% of patients who received HAART developed IRIS. Patients with IRIS were more likely to have initiated HAART nearer to the time of diagnosis of their opportunistic infection (P < 0.001), to have been antiretroviral naive at time of diagnosis of their opportunistic infection (P < 0.001), and to have a more rapid initial fall in HIV-1 RNA level in response to HAART (P < 0.001).Conclusions: IRIS is common among HIV-infected persons coinfected with M. tuberculosis, M. avium complex, or C. neoformans. Antiretroviral drug-naive patients who start HAART in close proximity to the diagnosis of an opportunistic infection and have a rapid decline in HIV-1 RNA level should be monitored for development of this disorder. (c) 2005 Lippincott Williams & Wilkins.