Bonham Shuli, Meya David B, Bohjanen Paul R, Boulware David R
Division of Infectious Disease & International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN.
Biomark Med. 2008;2(4):349-361. doi: 10.2217/17520363.2.4.349.
Dysregulation of the immune system drives HIV pathogenesis. As we develop new ways to treat HIV and AIDS, we encounter new clinical ramifications of our treatment on regulatory components of the immune system. HIV-associated Immune Reconstitution Inflammatory Syndrome (IRIS) occurs after initiation of anti-retroviral therapy (ART) with inappropriate and dysbalanced restoration of the immune system resulting in pathologic inflammatory reactions with significant morbidity. IRIS is most commonly associated with latent, occult, or past infections, including tuberculosis, Cryptococcus neoformans, and Mycobacterium avium-complex. We discuss common clinical presentations, new diagnostic modalities, current hypotheses of IRIS pathogenesis, and future directions of IRIS-related research, focusing on the identification of biomarkers that can be used to predict and diagnose IRIS.
免疫系统失调推动了HIV发病机制。在我们开发治疗HIV和艾滋病的新方法时，我们遇到了治疗对免疫系统调节成分产生的新临床影响。HIV相关免疫重建炎症综合征（IRIS）发生在开始抗逆转录病毒治疗（ART）后，免疫系统恢复不当且失衡，导致病理性炎症反应并伴有严重发病情况。IRIS最常与潜伏、隐匿或既往感染相关，包括结核病、新型隐球菌和鸟分枝杆菌复合体。我们讨论了常见的临床表现、新的诊断方法、IRIS发病机制的当前假说以及IRIS相关研究的未来方向，重点是识别可用于预测和诊断IRIS的生物标志物。
