The immunopathogenesis of the HIV tuberculosis immune reconstitution inflammatory syndrome

被引：36

作者：

Lai, Rachel P. J. ^{[1
]}

Nakiwala, Justine K. ^{[2
,3
,4
]}

Meintjes, Graeme ^{[2
,5
]}

Wilkinson, Robert J. ^{[1
,2
,5
]}

机构：

[1] Natl Inst Med Res, MRC, London NW7 1AA, England

[2] Univ Cape Town, Inst Infect Dis & Mol Med, Clin Infect Dis Res Initiat, ZA-7925 Cape Town, South Africa

[3] Inst Trop Med, B-2000 Antwerp, Belgium

[4] MRC UVRI Uganda HIV Res Unit AIDS, Entebbe, Uganda

[5] Univ London Imperial Coll Sci Technol & Med, Dept Med, London, England

来源：

EUROPEAN JOURNAL OF IMMUNOLOGY | 2013年 / 43卷 / 08期

基金：

英国惠康基金;

关键词：

Drug therapy complications; HIV-1; infection; Immune reconstitution inflammatory syndrome; Tuberculosis; CD4(+) T-CELLS; ACQUIRED-IMMUNODEFICIENCY-SYNDROME; STARTING ANTIRETROVIRAL THERAPY; VITAMIN-D STATUS; RESTORATION-DISEASE; INFECTED PATIENTS; HIV-1-INFECTED PATIENTS; MYCOBACTERIUM-TUBERCULOSIS; KAPOSI-SARCOMA; RESPONSES;

D O I：

10.1002/eji.201343632

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

HIV-1 patients co-infected with some pathogens are at risk of developing the immune reconstitution inflammatory syndrome (IRIS) when initiating antiretroviral therapy (ART). IRIS is characterized by inflammation leading to the clinical worsening of a treated infection or the unmasking of a previously undiagnosed condition or infection. It is commonly associated with tuberculosis (TB), 8-43% of the HIV-TB co-infected patients prescribed with antitubercular treatment and ART develop TB-IRIS. Although IRIS has been recognized for over 20 years, relatively little was known until recently about its pathogenesis. Despite these advances in understanding IRIS, there remains no immune biomarker for diagnostic or prognostic purposes. Here, we review the risk factors associated with TB-IRIS, the challenges in studying this syndrome, and how Tlymphocytes, dysregulated cytokine responses, and innate immunity may contribute to the development of TB-IRIS.

引用

页码：1995 / 2002

页数：8

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