Tuberculosis-associated Immune Reconstitution Inflammatory Syndrome and Unmasking of Tuberculosis by Antiretroviral Therapy
Tuberculosis-associated Immune Reconstitution Inflammatory Syndrome and Unmasking of Tuberculosis by Antiretroviral Therapy
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DOI：
10.1016/j.ccm.2009.08.013
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发表时间：
2009-12-01
影响因子：
5.7
通讯作者：
Cotton, Mark F.
中科院分区：
文献类型：
--
作者：
Meintjes, Graeme;Rabie, Helena;Cotton, Mark F.
结核病相关免疫重建炎症综合征（TB-IRIS）是用于治疗HIV-1感染的抗逆转录病毒治疗（ART）的常见早期并发症，特别是在结核病流行的国家。TB-IRIS的特征在于对结核分枝杆菌抗原的过度炎症反应，导致在早期ART期间经历免疫恢复的患者的临床恶化。TB-IRIS的两种形式被识别：矛盾的和暴露的。副结核-IRIS表现为新的或复发的结核病症状或体征的患者正在接受治疗的结核病在早期的ART，和揭露结核-IRIS的特点是夸大的，不寻常的炎性结核病在早期的ART。在这篇综述中的发病率，临床特点，危险因素，治疗和预防结核-IRIS在成人和儿童患者进行了讨论。
The tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is a frequent early complication of antiretroviral therapy (ART), used to treat HIV-1 infection, especially in countries where TB is prevalent. TB-IRIS is characterized by an exaggerated inflammatory response toward the antigens of Mycobacterium tuberculosis that results in clinical deterioration in patients experiencing immune recovery during early ART. Two forms of TB-IRIS are recognized: paradoxical; and unmasking. Paradoxical TB-IRIS manifests with new or recurrent TB symptoms or signs in patients being treated for TB during early ART, and unmasking TB-IRIS is characterized by an exaggerated, unusually inflammatory initial presentation of TB during early ART. In this review the incidence, clinical features, risk factors, treatment, and prevention of TB-IRIS in adult and pediatric patients are discussed.