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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Management of the immune reconstitution inflammatory syndrome
Current HIV/AIDS Reports, Volume 9, No. 3, Year 2012
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Description
The immune reconstitution inflammatory syndrome (IRIS) is a frequent early complication of antiretroviral therapy (ART) in patients with advanced HIV. Because there is no confirmatory diagnostic test, the diagnosis is based on clinical presentation and exclusion of alternative causes for deterioration, such as antimicrobial drug resistance. Opportunistic infection treatment should be optimized. Mild cases may require symptomatic therapy alone or nonsteroidal anti-inflammatory drugs. Corticosteroids have been used to treat more severe cases of IRIS associated with mycobacterial and fungal infections. There is evidence from a randomized controlled trial that prednisone reduces morbidity and improves symptoms in paradoxical tuberculosis (TB)-IRIS. Neurological TB-IRIS is potentially life-threatening; high-dose corticosteroids are indicated and ART interruption should be considered if level of consciousness is depressed. When considering corticosteroid treatment clinicians should be aware of their side effects and only use them when the diagnosis of IRIS is certain. In viral forms of IRIS corticosteroids are generally avoided. © 2012 Springer Science+Business Media, LLC.
Authors & Co-Authors
Meintjes, Graeme Ayton
South Africa, Cape Town
Faculty of Health Sciences
South Africa, Cape Town
University of Cape Town
United Kingdom, London
Imperial College London
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Scriven, James E.
South Africa, Cape Town
Faculty of Health Sciences
South Africa, Cape Town
University of Cape Town
Marais, Suzaan S.
South Africa, Cape Town
Faculty of Health Sciences
Statistics
Citations: 89
Authors: 3
Affiliations: 4
Identifiers
Doi:
10.1007/s11904-012-0129-5
ISSN:
15483568
e-ISSN:
15483576
Research Areas
Infectious Diseases
Study Approach
Quantitative