Management of the immune reconstitution inflammatory syndrome

Current HIV/AIDS Reports

Volumn 9, Issue 3, 2012, Pages 238-250

  Meintjes, Graeme ^a,b,c,d   Scriven, James ^a,b   Marais, Suzaan ^a  

^a UNIVERSITY OF CAPE TOWN   (South Africa)

^b UNIVERSITY OF CAPE TOWN   (South Africa)

^c IMPERIAL COLLEGE LONDON   (United Kingdom)

^d LIVERPOOL SCHOOL OF TROPICAL MEDICINE   (United Kingdom)

Author keywords

AIDS; Antiretroviral therapy; Corticosteroids; Cryptococcosis; Cytomegalovirus; HIV; Immune reconstitution inflammatory syndrome; Kaposi's sarcoma; Mycobacterial disease; Progressive multifocal leukoencephalopathy; Tuberculosis; Viral hepatitis

Indexed keywords

CORTICOSTEROID; NONSTEROID ANTIINFLAMMATORY AGENT; PREDNISONE; RIFAMPICIN; ANTI HUMAN IMMUNODEFICIENCY VIRUS AGENT;

ANTIVIRAL THERAPY; ARTICLE; ATYPICAL MYCOBACTERIOSIS; AVASCULAR NECROSIS; BACTERIAL PNEUMONIA; CORTICOSTEROID THERAPY; CRYPTOCOCCAL MENINGITIS; CUSHINGOID SYNDROME; CYTOMEGALOVIRUS INFECTION; DEPRESSION; DRUG MEGADOSE; DYSGLYCEMIA; ESOPHAGUS CANDIDIASIS; FLUID RETENTION; HEMORRHAGIC GASTRITIS; HEPATITIS B; HEPATITIS C; HERPES SIMPLEX; HIV ASSOCIATED NEPHROPATHY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTED PATIENT; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; HYPERTENSION; IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME; KAPOSI SARCOMA; LUNG TUBERCULOSIS; LYMPHOMA; MANIA; NEPHROTOXICITY; NONHUMAN; OSTEOPOROSIS; PNEUMOCYSTIS PNEUMONIA; PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY; SIDE EFFECT; STRONGYLOIDIASIS; THRUSH; TOXIC HEPATITIS; TUBERCULOSIS; TUBERCULOUS MENINGITIS; UVEITIS; VAGINA CANDIDIASIS; ACQUIRED IMMUNE DEFICIENCY SYNDROME; AIDS RELATED COMPLEX; CHEMICALLY INDUCED DISORDER; FEMALE; IMMUNOLOGY; MALE; MYCOBACTERIOSIS; REVIEW; VIROLOGY;

ACQUIRED IMMUNODEFICIENCY SYNDROME; ADRENAL CORTEX HORMONES; AIDS-RELATED OPPORTUNISTIC INFECTIONS; ANTI-HIV AGENTS; ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL; FEMALE; HUMANS; IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME; MALE; MYCOBACTERIUM INFECTIONS; TUBERCULOSIS;

EID: 84871697367     PISSN: 15483568     EISSN: 15483576     Source Type: Journal    
DOI: 10.1007/s11904-012-0129-5     Document Type: Article

References (128)

1. French MA, Lenzo N, John M, et al. Immune restoration disease after the treatment of immunodeficient HIV-infected patients with highly active antiretroviral therapy. HIV Med. 2000;1:107-15.
2. Haddow LJ, Easterbrook PJ, Mosam A, et al. Defining immune reconstitution inflammatory syndrome: evaluation of expert opinion versus 2 case definitions in a South African cohort. Clin Infect Dis. 2009;49:1424-32.
3. Ratnam I, Chiu C, Kandala NB, Easterbrook PJ. Incidence and risk factors for immune reconstitution inflammatory syndrome in an ethnically diverse HIV type 1-infected cohort. Clin Infect Dis. 2006;42:418-27. (Pubitemid 43122323)
4. Haddow LJ, Colebunders R, Meintjes G, et al. Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions. Lancet Infect Dis. 2010;10:791-802
5. Meintjes G, Lawn SD, Scano F, et al. Tuberculosis-associated immune reconstitution inflammatory syndrome: case definitions for use in resource-limited settings. Lancet Infect Dis. 2008;8:516-23. (Pubitemid 352005824)
6. Burman W, Weis S, Vernon A, et al. Frequency, severity and duration of immune reconstitution events in HIV-related tuberculosis. Int J Tuberc Lung Dis. 2007;11:1282-9.
7. Boulware DR, Meya DB, Bergemann TL, et al. Clinical features and serum biomarkers in HIV immune reconstitution inflammatory syndrome after cryptococcal meningitis: a prospective cohort study. PLoS Med. 2010;7:e1000384. A prospective cohort study conducted in Uganda of patients with CM. A total of 45% developed paradoxical cryptococcal IRIS after starting ART. The risk of mortality was doubled in those who developed IRIS. A detailed analysis of biomarkers predictive of and associated with IRIS was performed.
8. Muller M, Wandel S, Colebunders R, Attia S, Furrer H, Egger M. Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10:251-61.
9. Pepper DJ, Marais S, Maartens G, et al. Neurologic manifestations of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome: a case series. Clin Infect Dis. 2009;48:e96-107.
10. Lawn SD, Meintjes G. Pathogenesis and prevention of immune reconstitution disease during antiretroviral therapy. Expert Rev Anti Infect Ther. 2011;9:415-30. A recently published review article that covered the immunopathogenesis of IRIS and strategies to prevent both unmasking and paradoxical forms of IRIS. The review focused particularly on IRIS associated with mycobacterial infections, cryptococcosis, and CMV.
11. Meintjes G, Wilkinson RJ, Morroni C, et al. Randomized placebo-controlled trial of prednisone for paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome. AIDS. 2010;24:2381-90. The first clinical trial to assess a treatment for IRIS. A total of 110 patients with paradoxical TB-IRIS were enrolled in this randomised placebo-controlled trial of a 4- week course of prednisone. Prednisone resulted in reduction in hospitalization and outpatient therapeutic procedures without an excess of severe infections or metabolic complications.
12. Lehloenya R, Meintjes G. Dermatologic manifestations of the immune reconstitution inflammatory syndrome. Dermatol Clin. 2006;24:549-70. vii. (Pubitemid 44436794)
13. Meintjes G, Rangaka MX, Maartens G, et al. Novel relationship between tuberculosis immune reconstitution inflammatory syndrome and antitubercular drug resistance. Clin Infect Dis. 2009;48:667-76.
14. Adcock IM. Glucocorticoid-regulated transcription factors. Pulm Pharmacol Ther. 2001;14:211-9. (Pubitemid 32619926)
15. Rhen T, Cidlowski JA.Antiinflammatory action of glucocorticoids- new mechanisms for old drugs. N Eng J Med. 2005;353:1711-23.
16. Payne DN, Adcock IM. Molecular mechanisms of corticosteroid actions. Paediatr Respir Rev. 2001;2:145-50. 17. (Pubitemid 32694560)
17. Zen M, Canova M, Campana C, et al. The kaleidoscope of glucorticoid effects on immune system. Autoimmun Rev. 2011;10:305-10.
18. Briel M, Bucher HC, Boscacci R, Furrer H. Adjunctive corticosteroids for Pneumocystis jiroveci pneumonia in patients with HIV-infection. Cochrane Database Syst Rev 2006:CD006150.
19. Hakim JG, Ternouth I, Mushangi E, Siziya S, Robertson V, Malin A. Double blind randomised placebo controlled trial of adjunctive prednisolone in the treatment of effusive tuberculous pericarditis in HIV seropositive patients. Heart. 2000;84:183-8. (Pubitemid 30619742)
20. Achenbach CJ, Harrington RD, Dhanireddy S, Crane HM, Casper C, Kitahata MM. Paradoxical immune reconstitution inflammatory syndrome in HIV-infected patients treated with combination antiretroviral therapy after AIDS-defining opportunistic infection. Clin Infect Dis. 2012;54:424-33
21. Kumarasamy N, Chaguturu S, Mayer KH, et al. Incidence of immune reconstitution syndrome in HIV/tuberculosis-coinfected patients after initiation of generic antiretroviral therapy in India. J Acquir Immune Defic Syndr. 2004;37:1574-6. (Pubitemid 39658195)
22. Manfredi R, Pieri F, Pileri SA, Chiodo F. The changing face of AIDS-related opportunism: cryptococcosis in the highly active antiretroviral therapy (HAART) era. Case reports and literature review. Mycopathologia. 1999;148:73-8. (Pubitemid 32044913)
23. Kaplan JE, Benson C, Holmes KH, Brooks JT, Pau A, Masur H. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Recomm Rep. 2009;58:1-207.
24. Nelson MR, Katlama C, Montaner JS, et al. The safety of tenofovir disoproxil fumarate for the treatment of HIV infection in adults: the first 4 years. AIDS. 2007;21:1273-81. (Pubitemid 46883481)
25. Morelle J, Labriola L, Lambert M, Cosyns JP, Jouret F, Jadoul M. Tenofovir-related acute kidney injury and proximal tubule dysfunction precipitated by diclofenac: a case of drug-drug interaction. Clin Nephrol. 2009;71:567-70.
26. Thwaites GE, Nguyen DB, Nguyen HD, et al. Dexamethasone for the treatment of tuberculous meningitis in adolescents and adults. N Engl J Med. 2004;351:1741-51.
27. Strang JI, Kakaza HH, Gibson DG, Girling DJ, Nunn AJ, Fox W. Controlled trial of prednisolone as adjuvant in treatment of tuberculous constrictive pericarditis in Transkei. Lancet. 1987;2:1418- 22. (Pubitemid 18010317)
28. Breen RA, Smith CJ, Bettinson H, et al. Paradoxical reactions during tuberculosis treatment in patients with and without HIV co-infection. Thorax. 2004;59:704-7. (Pubitemid 39061536)
29. McAllister WA, Thompson PJ, Al-Habet SM, RogersHJ. Rifampicin reduces effectiveness and bioavailability of prednisolone. Br Med J (Clin Res Ed). 1983;286:923-5. (Pubitemid 13152756)
30. Meintjes G, Skolimowska KH, Wilkinson KA, Matthews K, Tadokera R, Conesa-Botella A, Seldon R, Rangaka MX, Rebe K, Pepper DJ, Morroni C, Colebunders R, Maartens G, Wilkinson RJ. Corticosteroid modulated immune activation in the TB immune reconstitution inflammatory syndrome. AmJ Respir Crit CareMed. 2012. doi:10.1164/rccm.201201-00940c.
31. Michailidis C, Pozniak AL, Mandalia S, Basnayake S, Nelson MR, Gazzard BG. Clinical characteristics of IRIS syndrome in patients with HIV and tuberculosis. Antivir Ther. 2005;10:417-22. (Pubitemid 41151019)
32. Olalla J, Pulido F, Rubio R, et al. Paradoxical responses in a cohort of HIV-1-infected patients with mycobacterial disease. Int J Tuberc Lung Dis. 2002;6:71-5. (Pubitemid 34263548)
33. Breton G, Duval X, Estellat C, et al. Determinants of immune reconstitution inflammatory syndrome in HIV type 1-infected patients with tuberculosis after initiation of antiretroviral therapy. Clin Infect Dis. 2004;39:1709-12. (Pubitemid 39578550)
34. Lawn SD, Wood R. Hepatic involvement with tuberculosisassociated immune reconstitution disease. AIDS. 2007;21:2362-3. (Pubitemid 350287472)
35. Meintjes G, Sonderup MW. A practical approach to the diagnosis andmanagement of paradoxical tuberculosis immune reconstitution inflammatory syndrome. Contin Med Educ. 2011;29(10):410-7.
36. Torok ME, Yen NT, Chau TT, et al. Timing of initiation of antiretroviral therapy in human immunodeficiency virus (HIV)- associated tuberculous meningitis. Clin Infect Dis. 2011;52:1374- 83
37. Asselman V, Thienemann F, Pepper DJ, et al. Central nervous system disorders after starting antiretroviral therapy in South Africa. AIDS. 2010;24:2871-6.
38. Torok ME, Kambugu A, Wright E. Immune reconstitution disease of the central nervous system. Curr Opin HIV AIDS. 2008;3:438-45.
39. Dautremer J, Pacanowski J, Girard PM, Lalande V, Sivignon F, Meynard JL. A new presentation of immune reconstitution inflammatory syndrome followed by a severe paradoxical reaction in an HIV-1-infected patient with tuberculous meningitis. AIDS. 2007;21:381-2. (Pubitemid 46175055)
40. Tuon FF, Mulatti GC, Pinto WP, de Siqueira Franca FO, Gryschek RC. Immune reconstitution inflammatory syndrome associated with disseminated mycobacterial infection in p a t i en t s wi t h AIDS. AIDS Pa t ien t Care STDS. 2007;21:527-32. (Pubitemid 350194954)
41. Lee CH, Lui CC, Liu JW. Immune reconstitution syndrome in a patient with AIDS with paradoxically deteriorating brain tuberculoma. AIDS Patient Care STDS. 2007;21:234-9.
42. Manosuthi W, Kiertiburanakul S, Phoorisri T, Sungkanuparph S. Immune reconstitution inflammatory syndrome of tuberculosis among HIV-infected patients receiving antituberculous and antiretroviral therapy. J Infect. 2006;53:357-63. (Pubitemid 44688983)
43. Rajeswaran G, Becker JL, Michailidis C, Pozniak AL, Padley SP. The radiology of IRIS (immune reconstitution inflammatory syndrome) in patients with mycobacterial tuberculosis and HIV coinfection: appearances in 11 patients. Clin Radiol. 2006;61:833- 43. (Pubitemid 44340958)
44. Crump JA, Tyrer MJ, Lloyd-Owen SJ, Han LY, Lipman MC, Johnson MA. Miliary tuberculosis with paradoxical expansion of intracranial tuberculomas complicating human immunodeficiency virus infection in a patient receiving highly active antiretroviral therapy. Clin Infect Dis. 1998;26:1008-9. (Pubitemid 28180357)
45. Vidal JE, Cimerman S, Schiavon Nogueira R, et al. Paradoxical reaction during treatment of tuberculous brain abscess in a patient with AIDS. Rev Inst Med Trop Sao Paulo. 2003;45:177-8. (Pubitemid 36876490)
46. Lipman M, Breen R. Immune reconstitution inflammatory syndrome in HIV. Curr Opin Infect Dis. 2006;19:20-5. (Pubitemid 43032435)
47. World Health Organisation. Improving the diagnosis and treatment of smear-negative pulmonary and extrapulmonary tuberculosis among adults and adolescents. Recommendations for HIVprevalent resource-constrained settings. Geneva: WHO Press; 2006.
48. Phillips P, Bonner S, Gataric N, et al. Nontuberculous mycobacterial immune reconstitution syndrome in HIV-infected patients: spectrum of disease and long-term follow-up. Clin Infect Dis. 2005;41:1483-97. (Pubitemid 41579994)
49. Riddell J, Kaul DR, Karakousis PC, Gallant JE, Mitty J, Kazanjian PH. Mycobacterium avium complex immune reconstitution inflammatory syndrome: long term outcomes. J Transl Med. 2007;5:50.
50. Desimone Jr JA, Babinchak TJ, Kaulback KR, Pomerantz RJ. Treatment of Mycobacterium avium complex immune reconstitution disease in HIV-1-infected individuals. AIDS Patient Care STDS. 2003;17:617-22. (Pubitemid 38031549)
51. Benson CA, Williams PL, Currier JS, et al. A prospective, randomized trial examining the efficacy and safety of clarithromycin in combination with ethambutol, rifabutin, or both for the treatment of disseminated Mycobacterium avium complex disease in persons with acquired immunodeficiency syndrome. Clin Infect Dis. 2003;37:1234-43. (Pubitemid 37372514)
52. Cinti SK, Kaul DR, Sax PE, Crane LR, Kazanjian PH. Recurrence of Mycobacterium avium infection in patients receiving highlyactive antiretroviral therapy and antimycobacterial agents. Clin Infect Dis. 2000;30:511-4. (Pubitemid 30205297)
53. Lee YC, Lu CL, Lai CC, Tseng YT, Sun HY, Hung CC. Mycobacterium avium complex infection-related immune reconstitution inflammatory syndrome of the central nervous system in an HIV-infected patient: Case report and review. J Microbiol Immunol Infect. 2012 Jan 6. [Epub ahead of print].
54. Jenny-Avital ER. A patient with refractory disseminated Mycobacterium avium after immune-reconstitution localized MAC. AIDS Clin Care. 2003;15:24-6.
55. Sungkanuparph S, Filler Scott G, Chetchotisakd P, et al. Cryptococcal immune reconstitution inflammatory syndrome after antiretroviral therapy in AIDS patients with cryptococcal meningitis: a prospective multicenter study. Clin Infect Dis. 2009;49:931-4.
56. Shelburne SA, Darcourt J, White AC, et al. The role of immune reconstitution inflammatory syndrome in AIDS-related Cryptococcus neoformans disease in the era of highly active antiretroviral therapy. Clin Infect Dis. 2005;40:1049-52. (Pubitemid 40418316)
57. Bicanic T, Meintjes G, Rebe K, et al. Immune reconstitution inflammatory syndrome in HIV-associated cryptococcalmeningitis: a prospective study. J Acquir Immune Defic Syndr. 2009;51:130-4
58. Boulware DR, Bonham SC, Meya DB, et al. Paucity of initial cerebrospinal fluid inflammation in cryptococcal meningitis is associated with subsequent immune reconstitution inflammatory syndrome. J Infect Dis. 2010;202:962-70.
59. Lawn SD, Bekker L-G,Myer L, Orrell C,Wood R. Cryptococcocal immune reconstitution disease: a major cause of early mortality in a South African antiretroviral programme. AIDS. 2005;19:2050-2. (Pubitemid 41669038)
60. Perfect John R, Dismukes William E, Dromer F, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of America. Clin Infect Dis. 2010;50:291-322. The most recent Infectious Diseases Society of America guidelines for managing cryptococcal disease. These include recommendations on the management of elevated intracranial pressure in CM and use of corticosteroids in IRIS.
61. King MD, Perlino CA, Cinnamon J, Jernigan JA. Paradoxical recurrent meningitis following therapy of cryptococcal meningitis: an immune reconstitution syndrome after initiation of highly active antiretroviral therapy. Int J STD AIDS. 2002;13:724-6.
62. Lortholary O, Fontanet A, Mémain N, et al. Incidence and risk factors of immune reconstitution inflammatory syndrome complicating HIV-associated cryptococcosis in France. AIDS. 2005;19:1043-9. (Pubitemid 40961144)
63. Venkataramana A, Pardo CA, McArthur JC, et al. Immune reconstitution inflammatory syndrome in the CNS of HIV-infected patients. Neurology. 2006;67:383-8. (Pubitemid 44214957)
64. Scourfield A,Waters L, Tittle V, Martin T, Rockwood N, Gazzard B, Bower M, Nelson M. Azathioprine use as a novel treatment for cryptococcal immune reconstitution and inflammatory syndrome in HIV. 17th Annual Conference of the British HIV Association, Bournmouth, 2011, abstract P92.
65. Muller M, Wandel S, Colebunders R, Attia S, Furrer H, Egger M. Immune reconstitution inflammatory syndrome in patients starting antiretroviral therapy for HIV infection: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10:251-61. A systematic review and meta-analysis of the incidence and mortality associated with IRIS. A total of 16% of unselected patients who started ART developed any kind of IRIS. The highest incidence of paradoxical IRIS was in patients with CMV retinitis at ART initiation. IRIS was associated with 21% mortality in CM.
66. StewartMW. Optimal management of cytomegalovirus retinitis in patients with AIDS. Clin Ophthalmol. 2010;4:285-99
67. El-Bradey MH, Cheng L, Song MK, Torriani FJ, Freeman WR. Long-term results of treatment of macular complications in eyes with immune recovery uveitis using a graded treatment approach. Retina. 2004;24:376-82. (Pubitemid 38780466)
68. Karavellas MP, Azen SP, MacDonald JC, et al. Immune recovery vitritis and uveitis in AIDS: clinical predictors, sequelae, and treatment outcomes. Retina. 2001;21:1-9. (Pubitemid 32151755)
69. Henderson HW, Mitchell SM. Treatment of immune recovery vitritis with local steroids. Br J Ophthalmol. 1999;83:540-5. (Pubitemid 29213125)
70. Karavellas MP, Lowder CY, Macdonald C, Avila Jr CP, Freeman WR. Immune recovery vitritis associated with inactive cytomegalovirus retinitis: a new syndrome.Arch Ophthalmol. 1998;116:169- 75.
71. Arevalo JF, Mendoza AJ, Ferretti Y. Immune recovery uveitis in AIDS patients with cytomegalovirus retinitis treated with highly active antiretroviral therapy in Venezuela. Retina. 2003;23:495- 502. (Pubitemid 37071963)
72. ZegansME,Walton RC, Holland GN, O'Donnell JJ, JacobsonMA, Margolis TP. Transient vitreous inflammatory reactions associated with combination antiretroviral therapy in patients with AIDS and cytomegalovirus retinitis. Am J Ophthalmol. 1998;125:292-300. (Pubitemid 28124356)
73. Lin YC, Yang CH, Lin CP, et al. Cytomegalovirus retinitis and immune recovery uveitis in AIDS patients treated with highly active antiretroviral therapy in Taiwanese. Ocul Immunol Inflamm. 2008;16:83-7.
74. Morrison VL, Kozak I, LaBree LD, Azen SP, Kayicioglu OO, Freeman WR. Intravitreal triamcinolone acetonide for the treatment of immune recovery uveitis macular edema. Ophthalmology. 2007;114:334-9. (Pubitemid 46161779)
75. Sirimaharaj M, Robinson MR, Zhu M, et al. Intravitreal injection of triamcinolone acetonide for immune recovery uveitis. Retina. 2006;26:578-80. (Pubitemid 44620407)
76. Hu J, Coassin M, Stewart JM. Fluocinolone acetonide implant (Retisert) for chronic cystoid macular edema in two patients with AIDS and a history of cytomegalovirus retinitis. Ocul Immunol Inflamm. 2011;19:206-9.
77. Ufret-Vincenty RL, Singh RP, Lowder CY, Kaiser PK. Cytomegalovirus retinitis after fluocinolone acetonide (Retisert) implant. Am J Ophthalmol. 2007;143:334-5. (Pubitemid 46136145)
78. Dalessandro L, Bottaro E. Reactivation of CMV retinitis after treatment with subtenon corticosteroids for immune recovery uveitis in a patient with AIDS. Scand J Infect Dis. 2002;34:780-2. (Pubitemid 35386048)
79. Tan CS, Koralnik IJ. Progressive multifocal leukoencephalopathy and other disorders caused by JC virus: clinical features and pathogenesis. Lancet Neurol. 2010;9:425-37.
80. Harrison DM, Newsome SD, Skolasky RL, McArthur JC, Nath A. Immune reconstitution is not a prognostic factor in progressive multifocal leukoencephalopathy. J Neuroimmunol. 2011;238:81- 6.
81. Tan K, Roda R, Ostrow L, McArthur J, Nath A. PML-IRIS in patients with HIV infection: clinical manifestations and treatment with steroids. Neurology. 2009;72:1458-64. A case series and retrospective review of the literature reporting 54 patients with PML-IRIS. The clinical manifestations and outcomes of patients treated with and without corticosteroids are reported.
82. Tantisiriwat W, Tebas P, Clifford DB, Powderly WG, Fichtenbaum CJ. Progressive multifocal leukoencephalopathy in patients with AIDS receiving highly active antiretroviral therapy. Clin Infect Dis. 1999;28:1152-4. (Pubitemid 29203555)
83. Thurnher MM, Post MJ, Rieger A, Kleibl-Popov C, Loewe C, Schindler E. Initial and follow-up MR imaging findings in AIDS-related progressive multifocal leukoencephalopathy treated with highly active antiretroviral therapy. Am J Neuroradiol. 2001;22:977-84. (Pubitemid 32436244)
84. Falco V, Olmo M, del Saz SV, et al. Influence of HAART on the clinical course of HIV-1-infected patients with progressive multifocal leukoencephalopathy: results of an observational multicenter study. J Acquir Immune Defic Syndr. 2008;49:26-31.
85. Miralles P, Berenguer J, Lacruz C, et al. Inflammatory reactions in progressive multifocal leukoencephalopathy after highly active antiretroviral therapy. AIDS. 2001;15:1900-2. (Pubitemid 32939260)
86. Hoffmann C, Horst HA, Albrecht H, Schlote W. Progressive multifocal leucoencephalopathy with unusual inflammatory response during antiretroviral treatment. J Neurol Neurosurg Psychiatry. 2003;74:1142-4.
87. Marshall LJ, Major EO. Molecular regulation of JC virus tropism: insights into potential therapeutic targets for progressive multifocal leukoencephalopathy. J Neuroimmune Pharmacol. 2010;5:404-17.
88. Martinez JV, Mazziotti JV, Efron ED, et al. Immune reconstitution inflammatory syndrome associated with PML in AIDS: a treatable disorder. Neurology. 2006;67:1692- 4. (Pubitemid 44747950)
89. Berger Jr. Steroids for PML-IRIS: a double-edged sword? Neurology. 2009;72:1454-5. An editorial that summarizes the pro's and con's of corticosteroid treatment for PML-IRIS.
90. Cinque P, Koralnik IJ, Gerevini S, Miro JM, Price RW. Progressive multifocal leukoencephalopathy in HIV-1 infection. Lancet Infect Dis. 2009;9:625-36.
91. Berger JR, Levy RM, Flomenhoft D, Dobbs M. Predictive factors for prolonged survival in acquired immunodeficiency syndromeassociated progressive multifocal leukoencephalopathy. Ann Neurol. 1998;44:341-9. (Pubitemid 28421438)
92. Kotecha N, George MJ, Smith TW, Corvi F, Litofsky NS. Enhancing progressive multifocal leukoencephalopathy: an indicator of improved immune status? Am J Med. 1998;105:541- 3. (Pubitemid 29013342)
93. Du Pasquier RA, Koralnik IJ. Inflammatory reaction in progressive multifocal leukoencephalopathy: harmful or beneficial? J Neurovirol. 2003;9 Suppl 1:25-31. (Pubitemid 36656467)
94. Cattelan AM, Calabrò ML, Gasperini P, et al. Acquired immunodeficiency syndrome-related Kaposi's sarcoma regression after highly active antiretroviral therapy: biologic correlates of clinical outcome. J Natl Cancer Inst Monographs 2001;44-9.
95. Bower M, Nelson M, Young AM, et al. Immune reconstitution inflammatory syndrome associated with Kaposi's sarcoma. J Clin Oncol. 2005;23:5224-8. (Pubitemid 46224033)
96. Connick E, Kane MA, White IE, Ryder J, Campbell TB. Immune reconstitution inflammatory syndrome associated with Kaposi sarcoma during potent antiretroviral therapy. Clin Infect Dis. 2004;39:1852-5. (Pubitemid 39657269)
97. Weir A, Wansbrough-Jones M. Mucosal Kaposi's sarcoma following protease inhibitor therapy in an HIV-infected patient. AIDS. 1997;11:1895-6. (Pubitemid 27500974)
98. Letang E, Almeida JM, Miró JM, et al. Predictors of immune reconstitution inflammatory syndrome-associated with kaposi sarcoma in mozambique: a prospective study. J Acquir Immune Defic Syndr. 2010;53:589-97. A prospective cohort study conducted in Mozambique that reports the incidence, risk factors, management, and outcomes of KS-IRIS. The mortality in patients with KS-IRIS was 25%.
99. Leidner RS, Aboulafia DM. Recrudescent Kaposi's sarcoma after initiation of HAART: a manifestation of immune reconstitution syndrome. AIDS Patient Care STDS. 2005;19:635- 44. (Pubitemid 41527674)
100. Crane HM, Deubner H, Huang JC, Swanson PE, Harrington RD. Fatal Kaposi's sarcoma-associated immune reconstitution following HAART initiation. Int J STD AIDS. 2005;16:80-3.
101. Volkow PF, Cornejo P, Zinser JW, Ormsby CE, Reyes-Terán G. Life-threatening exacerbation of Kaposi's sarcoma after prednisone treatment for immune reconstitution inflammatory syndrome. AIDS. 2008;22:663-5. (Pubitemid 351640603)
102. Elliott AM, Luzze H, Quigley MA, et al. A randomized, doubleblind, placebo-controlled trial of the use of prednisolone as an adjunct to treatment in HIV-1-associated pleural tuberculosis. J Infect Dis. 2004;190:869-78. (Pubitemid 39120962)
103. Gill PS, Loureiro C, Bernstein-Singer M, Rarick MU, Sattler F, Levine AM. Clinical effect of glucocorticoids on Kaposi sarcoma related to the acquired immunodeficiency syndrome (AIDS). Ann Intern Med. 1989;110:937-40. (Pubitemid 19153781)
104. Ueno T, Mitsuishi T, Kimura Y, et al. Immune reconstitution inflammatory syndrome associated with Kaposi's sarcoma: successful treatment with interferon-alpha. Eur J Dermatol. 2007;17:539-40. (Pubitemid 350207170)
105. den Brinker M,Wit FW,Wertheim-van Dillen PM, et al. Hepatitis B and C virus co-infection and the risk for hepatotoxicity of highly active antiretroviral therapy in HIV-1 infection. AIDS. 2000;14:2895-902. (Pubitemid 32042753)
106. Sulkowski MS, Thomas DL, Chaisson RE, Moore RD. Hepatotoxicity associated with antiretroviral therapy in adults infected with human immunodeficiency virus and the role of hepatitis C or B virus infection. JAMA. 2000;283:74- 80. (Pubitemid 30038386)
107. Wit FWNM, Weverling GJ, Weel J, Jurriaans S, Lange JMA. Incidence of and risk factors for severe hepatotoxicity associated with antiretroviral combination therapy. J Infect Dis. 2002;186:23-31. (Pubitemid 34666910)
108. Drake A, Mijch A, Sasadeusz J. Immune reconstitution hepatitis in HIV and hepatitis B coinfection, despite lamivudine therapy as part of HAART. Clin Infect Dis. 2004;39:129-32. (Pubitemid 38879560)
109. Murcia JM, Boix V, Merino E, Manso MI, Portilla J. Drug toxicity or syndrome of immune restoration causing fulminant cirrhosis after HAART-induced immune recovery. Eur J Clin Micro Infect Dis. 2002;21:153-5. (Pubitemid 34212224)
110. Carr A, Cooper DA. Restoration of immunity to chronic hepatitis B infection in HIV-infected patient on protease inhibitor. Lancet. 1997;349:995-6. (Pubitemid 27149806)
111. Crane M, Matthews G, Lewin SR. Hepatitis virus immune restoration disease of the liver. Curr Opin HIV AIDS. 2008;3:446-52.
112. John M, Flexman J, French MA. Hepatitis C virus-associated hepatitis following treatment of HIV-infected patients with HIV protease inhibitors: an immune restoration disease? AIDS. 1998;12:2289-93. (Pubitemid 28526408)
113. Manegold C, Hannoun C, Wywiol A, et al. Reactivation of hepatitis B virus replication accompanied by acute hepatitis in patients receiving highly active antiretroviral therapy. Clin Infect Dis. 2001;32:144-8. (Pubitemid 32150960)
114. Rouanet I, Peyriere H, Mauboussin JM, Terrail N, Vincent D. Acute clinical hepatitis by immune restoration in a human immunodeficiency virus/hepatitis B virus co-infected patient receiving antiretroviral therapy. Eur J Gastroenterol Hepatol. 2003;15:95-7. (Pubitemid 36135670)
115. Velasco M, Moran A, Tellez MJ. Resolution of chronic hepatitis B after ritonavir treatment in an HIV-infected patient. N Eng J Med. 1999;340:1765-6. (Pubitemid 29252611)
116. Nüesch R, Ananworanich J, Srasuebkul P, et al. Interruptions of tenofovir/emtricitabine-based antiretroviral therapy in patients with HIV/hepatitis B virus co-infection. AIDS. 2008;22:152-4. (Pubitemid 350294891)
117. Calabrese LH, Zein NN, Vassilopoulos D. Hepatitis B virus (HBV) reactivation with immunosuppressive therapy in rheumaticdiseases: assessment and preventive strategies. Ann Rheum Dis. 2006;65:983-9. (Pubitemid 44133258)
118. Sagnelli E, Manzillo G, Maio G, et al. Serum levels of hepatitis B surface and core antigens during immunosuppressive treatment of HBsAg-positive chronic active hepatitis. Lancet. 1980;2:395-7. (Pubitemid 10056533)
119. McGee S, Hirschmann J. Use of corticosteroids in treating infectious diseases. Arch Intern Med. 2008;168:1034-46. (Pubitemid 351749220)
120. Baker JV, Boulware DR, Bohjanen PR. A case for treating high hepatitis B DNA levels before starting HIV therapy. AIDS. 2006;20:2402-3. (Pubitemid 44789549)
121. Hardwick C, White D, Morris E, Monteiro EF, Breen RA, Lipman M. Montelukast in the treatment of HIV associated immune reconstitution disease. Sex Transm Infect. 2006;82:513-4. (Pubitemid 46025198)
122. Marais S, Wilkinson RJ, Pepper DJ, Meintjes G. Management of patients with the immune reconstitution inflammatory syndrome. Curr HIV/AIDS Rep. 2009;6:162-71.
123. Tadokera R,MeintjesG, SkolimowskaKH, et al.Hypercytokinaemia accompanies HIV-tuberculosis immune reconstitution inflammatory syndrome. Eur Resp J. 2011;37:1248-59.
124. Blackmore TK,Manning L, TaylorWJ,Wallis RS. Therapeutic use of infliximab in tuberculosis to control severe paradoxical reaction of the brain and lymph nodes. Clin Infect Dis. 2008;47:e83-5.
125. Hennigan S, Kavanaugh A. Interleukin-6 inhibitors in the treatment of rheumatoid arthritis. Ther Clin Risk Manag. 2008;4:767-75.
126. Martin-Blondel G, Cuzin L, Delobel P, et al. Is maraviroc beneficial in paradoxical progressive multifocal leukoencephalopathyimmune reconstitution inflammatory syndrome management? AIDS. 2009;23:2545-6.
127. Sun HY, Singh N. Potential role of statins for the management of immune reconstitution syndrome.Med Hypotheses. 2011;76:307-10.
128. Gallant JE, Chaisson RE, Moore RD. The effect of adjunctive corticosteroids for the treatment of Pneumocystis carinii pneumonia on mortality and subsequent complications. Chest. 1998;114:1258-63. (Pubitemid 28527395)