Reyes-Corcho Andrés, Bouza-Jiménez Yadira
Servicio de Enfermedades Infecciosas, Hospital Universitario Dr. Gustavo Aldereguía Lima, Cienfuegos, Cuba.
Enferm Infecc Microbiol Clin. 2010 Feb;28(2):110-21. doi: 10.1016/j.eimc.2009.03.007. Epub 2009 Jul 26.
Since the arrival of highly active antiretroviral therapy (HAART), immune reconstitution syndrome (IRS) has become an increasingly more frequent complication in patients with human immunodeficiency virus (HIV) infection. This article presents a review of the available evidence on this subject, indexed in MEDLINE-PUBMED, BVS-BIREME, and BioMed Central. The review covers the definition, epidemiology, classification, and diagnostic criteria related to IRS. In addition, the clinical particularities of the most frequent etiologies are described, and a proposal for a therapeutic approach is formulated. The prognosis and future implications of this syndrome in the epidemiology of some infectious illnesses in the HIV-positive population are included. Several unresolved aspects are mentioned, such as those related to the pathophysiology of the condition, use of biomarkers for the diagnosis, and the need for evidence-based therapeutic algorithms to enable standardization of treatment for these patients.
自从高效抗逆转录病毒疗法(HAART)问世以来,免疫重建综合征(IRS)在人类免疫缺陷病毒(HIV)感染患者中已成为越来越常见的并发症。本文对MEDLINE-PUBMED、BVS-BIREME和BioMed Central索引的关于该主题的现有证据进行了综述。该综述涵盖了与IRS相关的定义、流行病学、分类和诊断标准。此外,还描述了最常见病因的临床特点,并制定了治疗方法建议。文中还包括了该综合征在HIV阳性人群某些传染病流行病学中的预后及未来影响。文中提到了几个尚未解决的方面,例如与该病症病理生理学相关的方面、用于诊断的生物标志物的使用,以及需要基于证据的治疗算法以使这些患者的治疗标准化。