Stoll Matthias, Schmidt Reinhold E
Department Clinical Immunology, Medical School Hannover, Carl Neuberg Street 1, D-30625 Hannover, Germany.
Curr HIV/AIDS Rep. 2004 Sep;1(3):122-7. doi: 10.1007/s11904-004-0018-7.
Immune reconstitution occurs after initiation of highly active antiretroviral therapy in immunodeficient HIV-positive individuals. Unexpected deterioration of inflammatory disease and atypical clinical features resembling symptoms of autoimmune disease may arise. These atypical inflammatory disorders, synonymously summarized as immune reconstitution syndrome, immune restoration disease, and immune restoration inflammatory syndrome (IRIS), are caused by augmentation of inflammation during immune reconstitution in an immunocompromised host. These disorders have to be distinguished from intercurrent infection and rheumatic disease, respectively. Treatment of IRIS consists of elements for both potential differential diagnoses (ie, anti-inflammatory and immunosuppressive drugs, such as in autoimmune disorders and antimicrobial chemotherapy, to decrease the burden of pathogen, such as in infectious disease). Therefore, awareness for IRIS is of increasing importance from a clinical point of view. However, diagnostic criteria and standards of treatment are still preliminary.
免疫重建发生在免疫缺陷的HIV阳性个体开始高效抗逆转录病毒治疗之后。可能会出现炎症性疾病意外恶化以及类似自身免疫性疾病症状的非典型临床特征。这些非典型炎症性疾病，统称为免疫重建综合征、免疫恢复疾病和免疫恢复炎症综合征（IRIS），是由免疫受损宿主免疫重建过程中炎症增强所致。这些疾病必须分别与并发感染和风湿性疾病相鉴别。IRIS的治疗包括针对两种潜在鉴别诊断的要素（即抗炎和免疫抑制药物，如用于自身免疫性疾病，以及抗微生物化疗，以减轻病原体负担，如用于传染病）。因此，从临床角度来看，对IRIS的认识越来越重要。然而，诊断标准和治疗规范仍处于初步阶段。
