Immune reconstitution inflammatory syndrome in a large multicenter cohort study: case definition and comparability

2012 ◽  
Vol 10 (7) ◽  
pp. 737-741 ◽  
Author(s):  
Graeme Meintjes ◽  
Andrew Boulle
Keyword(s):  
Cohort Study ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Case Definition ◽  
Multicenter Cohort Study ◽  
Multicenter Cohort ◽  
Study Case ◽  
Inflammatory Syndrome

Clinical case definition and manifestations of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome

AIDS ◽  
2009 ◽  
Vol 23 (18) ◽  
pp. 2467-2471 ◽  
Author(s):  
Weerawat Manosuthi ◽  
Hong Van Tieu ◽  
Wiroj Mankatitham ◽  
Aroon Lueangniyomkul ◽  
Jintanat Ananworanich ◽  
...  
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Clinical Case ◽  
Case Definition ◽  
Inflammatory Syndrome ◽  
Clinical Case Definition

scholarly journals Declines in Lung Function After Antiretroviral Therapy Initiation in Adults With Human Immunodeficiency Virus and Tuberculosis: A Potential Manifestation of Respiratory Immune Reconstitution Inflammatory Syndrome

2019 ◽  
Vol 70 (8) ◽  
pp. 1750-1753 ◽  
Author(s):  
Sara C Auld ◽  
Pholo Maenetje ◽  
Shruthi Ravimohan ◽  
Drew Weissman ◽  
Itai Ncube ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Lung Function ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Research Attention ◽  
Therapy Initiation ◽  
Immunodeficiency Virus ◽  
Inflammatory Syndrome

Abstract End-organ impairment has received relatively little research attention as a possible manifestation of tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS). In this prospective cohort study, one-half of adults with human immunodeficiency virus and pulmonary tuberculosis experienced meaningful declines in lung function on antiretroviral therapy, suggesting a role for lung function in TB-IRIS definitions.

Validation of a published case definition for tuberculosis-associated immune reconstitution inflammatory syndrome

AIDS ◽  
2010 ◽  
Vol 24 (1) ◽  
pp. 103-108 ◽  
Author(s):  
Lewis J Haddow ◽  
Mahomed-Yunus S Moosa ◽  
Philippa J Easterbrook
Keyword(s):  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Case Definition ◽  
Inflammatory Syndrome

Unmasking Lymphoma Immune Reconstitution Inflammatory Syndrome Among HIV-Infected Individuals In The Center For AIDS Research Network Of Integrated Clinical Systems

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4331-4331
Author(s):  
Satish Gopal ◽  
Monita Patel ◽  
Elizabeth Yanik ◽  
Greer Burkholder ◽  
Erin Reid ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
Case Definition ◽  
Research Network ◽  
Hiv Rna ◽  
Art Initiation ◽  
Aids Research ◽  
Inflammatory Syndrome ◽  
Clinical Systems

Abstract Introduction Cohort studies have demonstrated increased incidence of Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) among HIV-infected individuals during the first 6 months after antiretroviral therapy (ART) initiation, perhaps due to unmasking immune reconstitution inflammatory syndrome (IRIS). Unmasking IRIS is characterized by the diagnosis of a new HIV-associated condition soon after ART that was not apparent prior to ART, coupled with evidence of ART effectiveness. It has been well described for opportunistic infections and Kaposi sarcoma. However, clinical characteristics and survival for unmasking lymphoma IRIS have not been described. Methods We studied lymphoma patients in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) from 1996 until 2011. Unmasking lymphoma IRIS was defined as HL or NHL occurring within 6 months after ART initiation accompanied by a ≥0.5 log10copies/mL reduction in HIV RNA between values taken prior to ART and at lymphoma diagnosis. Differences in presentation and survival were examined between lymphoma IRIS and non-IRIS cases. Results Of 482 lymphoma patients, 48 (10%) met criteria for unmasking lymphoma IRIS. Of these, 10 (21%) had HL, 19 (40%) diffuse large B-cell lymphoma (DLBCL), 4 (8%) Burkitt lymphoma (BL), 9 (19%) primary central nervous system lymphoma (PCNSL), and 6 (12%) other NHL (Table). Median CD4 cell count at lymphoma diagnosis among IRIS cases was 163 cells/mL (interquartile range 67-302), and 54% had suppressed HIV RNA (< 400 copies/ml). No significant differences were identified between lymphoma IRIS and non-IRIS cases, with the exception of possible earlier stage (47% stage I/II versus 24%, p=0.03), more frequent hepatitis B/C co-infection (31% versus 19%, p=0.05), and more frequent prior AIDS illness (92% versus 79%, p=0.05), as well as expected lower HIV RNA at lymphoma diagnosis likely resulting from the IRIS case definition. Additionally, no differences in cumulative mortality 5 years after lymphoma diagnosis were identified between IRIS and non-IRIS cases, although there was a suggestion of increased early mortality among IRIS cases (Figure). Conclusions In a large HIV-associated lymphoma cohort in the United States, 10% of patients met a standardized unmasking lymphoma IRIS case definition. No major differences between lymphoma IRIS and non-IRIS cases were identified. Possible effects of subclinical lymphoma leading to care seeking behavior and subsequent ART initiation prior to lymphoma diagnosis could not be excluded. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Immune Reconstitution Inflammatory Syndrome During the First Six Months of Receiving Antiretroviral in HIV-Infected Individuals: A Retrospective Cohort Study

2019 ◽  
Vol 3 (1) ◽  
pp. 01-04
Author(s):  
Faustine Tungaraza ◽  
Augustino S. Kahere ◽  
George M. Bwire ◽  
Doreen Mloka ◽  
Fatuma F. Felician
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Immune Reconstitution ◽  
Cd4 Cells ◽  
Inflammatory Syndrome

Introduction: Immune reconstitution inflammatory syndrome (IRIS) is referred to as the flare up of an underlying, previously undiagnosed infection or the worsening of a previously treated infection soon after antiretroviral therapy (ART) is started. Information about the prevalence and associated risk factors for IRIS in resource-constrained countries like Tanzania where access to ART is increasing is scarce. Therefore, this study was conducted to determine the prevalence and risk factors associated with IRIS among patients attending care and treatment clinic at Muhimbili National Hospital (CTC-MNH). Methods: A retrospective cohort study was conducted in patients receiving highly active antiretroviral therapy (HAART) who attended CTC-MNH between July 2016 and June 2018. Mann Whitney test was used to compare median CD4+ cells count and viral load at baseline and after 6 months of treatment. Associated factors were analysed using multi-logistic regression. Statistics were done using GraphPad Prism 7 software and a p-value < 0.05 was considered statistically significant. Results: Of 318 patients, 8.5% encountered IRIS. Compared to baseline readings, there were significant increases in CD4+ cells (P < 0.0001) and decrease in viral load count (P < 0.0001). Patients who did not adhere to HAART were more likely to develop IRIS [Adjusted Odds Ratio (AOR) = 4.2, 95% CI; 1.14-15.60, P = 0.03]. Conclusion: This study found relatively low prevalence of IRIS as compared to those reported elsewhere. Moreover, poor adherence to HAART was found to be a risk factor for IRIS.

scholarly journals Immune Reconstitution Inflammatory Syndrome and the Influence of T Regulatory Cells: A Cohort Study in the Gambia

PLoS ONE ◽  
2012 ◽  
Vol 7 (6) ◽  
pp. e39213 ◽  
Author(s):  
Irfan Zaidi ◽  
Kevin Peterson ◽  
David Jeffries ◽  
Hilton Whittle ◽  
Thushan de Silva ◽  
...  
Keyword(s):  
Cohort Study ◽  
Immune Reconstitution Inflammatory Syndrome ◽  
Immune Reconstitution ◽  
T Regulatory Cells ◽  
The Gambia ◽  
Regulatory Cells ◽  
Inflammatory Syndrome
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