Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory 7925, South Africa.
Clin Chest Med. 2009 Dec;30(4):797-810, x. doi: 10.1016/j.ccm.2009.08.013.
The tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) is a frequent early complication of antiretroviral therapy (ART), used to treat HIV-1 infection, especially in countries where TB is prevalent. TB-IRIS is characterized by an exaggerated inflammatory response toward the antigens of Mycobacterium tuberculosis that results in clinical deterioration in patients experiencing immune recovery during early ART. Two forms of TB-IRIS are recognized: paradoxical; and unmasking. Paradoxical TB-IRIS manifests with new or recurrent TB symptoms or signs in patients being treated for TB during early ART, and unmasking TB-IRIS is characterized by an exaggerated, unusually inflammatory initial presentation of TB during early ART. In this review the incidence, clinical features, risk factors, treatment, and prevention of TB-IRIS in adult and pediatric patients are discussed.
结核相关免疫重建炎症综合征（TB-IRIS）是抗逆转录病毒治疗（ART）的一种常见早期并发症，用于治疗 HIV-1 感染，尤其是在结核病流行的国家。TB-IRIS 的特征是针对结核分枝杆菌抗原的过度炎症反应，导致在早期 ART 期间经历免疫恢复的患者临床恶化。TB-IRIS 有两种形式：矛盾型和揭示型。矛盾型 TB-IRIS 表现为在早期 ART 期间正在接受结核病治疗的患者出现新的或复发的结核病症状或体征，揭示型 TB-IRIS 的特征是在早期 ART 期间结核的初始表现异常炎症。在这篇综述中，讨论了成人和儿科患者中 TB-IRIS 的发生率、临床特征、危险因素、治疗和预防。
