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The immunopathogenesis of the HIV tuberculosis immune reconstitution inflammatory syndrome
Author(s) -
Lai Rachel P. J.,
Nakiwala Justine K.,
Meintjes Graeme,
Wilkinson Robert J.
Publication year - 2013
Publication title -
european journal of immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.272
H-Index - 201
eISSN - 1521-4141
pISSN - 0014-2980
DOI - 10.1002/eji.201343632
Subject(s) - immune reconstitution inflammatory syndrome , immunology , tuberculosis , immune system , iris (biosensor) , pathogenesis , innate immune system , inflammation , immunity , biology , medicine , human immunodeficiency virus (hiv) , antiretroviral therapy , viral load , pathology , computer security , computer science , biometrics
HIV‐1 patients co‐infected with some pathogens are at risk of developing the immune reconstitution inflammatory syndrome ( IRIS ) when initiating antiretroviral therapy (ART). IRIS is characterized by inflammation leading to the clinical worsening of a treated infection or the unmasking of a previously undiagnosed condition or infection. It is commonly associated with tuberculosis ( TB ), 8–43% of the HIV ‐ TB co‐infected patients prescribed with antitubercular treatment and ART develop TB ‐ IRIS . Although IRIS has been recognized for over 20 years, relatively little was known until recently about its pathogenesis. Despite these advances in understanding IRIS , there remains no immune biomarker for diagnostic or prognostic purposes. Here, we review the risk factors associated with TB ‐ IRIS , the challenges in studying this syndrome, and how T lymphocytes, dysregulated cytokine responses, and innate immunity may contribute to the development of TB ‐ IRIS .