Tuberculosis-associated Immune Reconstitution Inflammatory Syndrome and Unmasking of Tuberculosis by Antiretroviral Therapy - 21/05/15
, Helena Rabie, MBChB, FCPaed(SA), MMed Paed d, Robert J. Wilkinson, MA, BM, BCh, PhD, DTM&H a, b, c, e, f, Mark F. Cotton, MMed(Paed), FCPaed(SA), DCH(SA), DTM&H, PhD d
Corresponding author. Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, South Africa.Resumen |
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.
El texto completo de este artículo está disponible en PDF.Keywords : Immune reconstitution inflammatory syndrome, HIV, Tuberculosis, Antiretroviral therapy
Esquema
| GM and RJW are supported by the Wellcome Trust (072070, 084323, 088316, 081667). |
Vol 30 - N° 4
P. 797-810 - décembre 2009 Regresar al número
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