Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions.
Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions.
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DOI：
10.1016/s1473-3099(10)70170-5
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发表时间：
2010-11
期刊：
影响因子：
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通讯作者：
International Network for the Study of HIV-associated IRIS (INSHI)
中科院分区：
文献类型：
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作者：
Haddow LJ;Colebunders R;Meintjes G;Lawn SD;Elliott JH;Manabe YC;Bohjanen PR;Sungkanuparph S;Easterbrook PJ;French MA;Boulware DR;International Network for the Study of HIV-associated IRIS (INSHI)
隐球菌免疫重建炎症综合征 (C-IRIS) 可能表现为开始抗逆转录病毒治疗 (ART) 后隐球菌疾病的临床恶化或新表现，并且被认为是由隐球菌特异性免疫反应恢复引起的。我们回顾了有关 C-IRIS 的现有文献，以指导制定针对 ART 前已知隐球菌病患者的矛盾隐球菌 IRIS 的共识病例定义，以及 ART 期间发生的隐球菌病事件病例（此处称为 ART 相关隐球菌病）的第二个定义，其中一部分可能“揭露”C-IRIS。这些结构化病例定义旨在用于 C-IRIS 未来的临床、流行病学和免疫病理学研究，协调诊断标准，并促进研究之间的比较。与结核病相关的 IRIS 一样，这些提出的定义应被视为初步定义，直到对 IRIS 免疫病理学的进一步了解允许其完善为止。
Cryptococcal immune reconstitution inflammatory syndrome (C-IRIS) may present as a clinical deterioration or new presentation of cryptococcal disease following initiation of antiretroviral therapy (ART) and is believed to be caused by recovery of cryptococcus-specific immune responses. We have reviewed the existing literature on C-IRIS to inform the development of a consensus case definition specific for paradoxical cryptococcal IRIS in patients with known cryptococcal disease prior to ART, and a second definition for incident cases of cryptococcosis developing during ART (here termed ART-associated cryptococcosis), a proportion of which are likely to be “unmasking” C-IRIS. These structured case definitions are intended for use in future clinical, epidemiologic and immunopathologic studies of C-IRIS, harmonizing diagnostic criteria, and facilitating comparisons between studies. As with tuberculosis-associated IRIS, these proposed definitions should be regarded as preliminary until further insights into the immunopathology of IRIS permit their refinement.