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08:43
Adoptive Immunotherapy of iNKT Cells in Glucose-6-Phosphate Isomerase (G6PI)-Induced RA Mice
Published on: January 31, 2020
Immune reconstitution inflammatory syndrome.
1Positive Health Program at San Francisco General Hospital, University of California San Francisco, Building 80, Ward 84, 995 Potrero Avenue, San Francisco, CA 94110, USA. gbeatty@php.ucsf.edu
Emergency Medicine Clinics of North America
|April 24, 2010
Summary
Immune reconstitution inflammatory syndrome (IRIS) is a diagnostic challenge in HIV patients starting ART. Differentiating IRIS from active infections is crucial for appropriate management, with steroids beneficial in severe cases.
Area of Science:
- Infectious Diseases
- Immunology
- HIV Medicine
Background:
- Immune reconstitution inflammatory syndrome (IRIS) is a significant concern in HIV-infected individuals initiating antiretroviral therapy (ART).
- IRIS presents a diagnostic challenge, often mimicking active infections with atypical presentations.
- Commonly associated conditions include mycobacterial and cryptococcal infections, alongside dermatologic manifestations.
Purpose of the Study:
- To highlight the importance of considering IRIS in the differential diagnosis for HIV patients on ART.
- To emphasize the diagnostic challenges in distinguishing IRIS from active infections in acute care settings.
- To discuss the clinical significance and management strategies for IRIS.
Main Methods:
- Review of clinical presentations and diagnostic considerations for IRIS.
- Analysis of common pathogens and atypical manifestations associated with IRIS.
- Evaluation of management strategies, including the role of systemic steroids and ART interruption.
Main Results:
- IRIS presentations are frequently atypical for the causative pathogen.
- Central nervous system, pulmonary, and ocular involvements are the most clinically significant complications.
- Systemic steroids offer therapeutic benefits in many severe IRIS cases.
Conclusions:
- IRIS requires careful consideration in HIV patients starting ART.
- Accurate differentiation from active infection is critical for patient outcomes.
- ART interruption is rarely indicated, except in life-threatening IRIS complications.
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