Management of the immune reconstitution inflammatory syndrome.
Curr HIV/AIDS Rep
; 9(3): 238-50, 2012 Sep.
Article
en En
| MEDLINE
| ID: mdl-22752438
ABSTRACT
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.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Tuberculosis
/
Síndrome de Inmunodeficiencia Adquirida
/
Infecciones Oportunistas Relacionadas con el SIDA
/
Fármacos Anti-VIH
/
Síndrome Inflamatorio de Reconstitución Inmune
/
Infecciones por Mycobacterium
Tipo de estudio:
Clinical_trials
Límite:
Female
/
Humans
/
Male
Idioma:
En
Año:
2012
Tipo del documento:
Article