Murthy Anup R, Marulappa Rekha, Hegde Usha, Kappadi Damodhar, Ambikathanaya U K, Nair Priyanka
Reader, Department of Orthodontics, Mathrusri Ramabai Ambedkar Dental College and Hospital, Bengaluru, Karnataka, India.
Post-graduate, Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, Mysore, Karnataka, India.
J Int Oral Health. 2015 Apr;7(4):92-5.
Immune reconstitution inflammatory syndrome (IRIS) is an "unmasking" or paradoxical worsening of a pre-existing infection after commencement of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV) - infected patients. The use of HAART in the management of HIV patients restores immune responses against pathogens however in few patients, the reconstituted immune system leads to IRIS. As the treatment protocols are not standardized for IRIS, this leads to short-term morbidity or in some cases also mortality. Therefore, treatment in these patients is a huge challenge and further more research regarding the immunopathogenesis, diagnosis and management of IRIS should be well thought-out. To understand the immunopathogenesis of IRIS it will be difficult to elucidate the intrinsic dynamics of immune cells after initiation of HAART but, there are few biomarkers which help to predict or diagnose IRIS and develop specific treatment, following initiation of HIV therapy. This review is an attempt to put light on those patients with IRIS with treatment guidelines for the management of the progression of it.
免疫重建炎症综合征（IRIS）是指人类免疫缺陷病毒（HIV）感染患者在开始高效抗逆转录病毒治疗（HAART）后，先前存在的感染出现“暴露”或矛盾性恶化。在HIV患者的治疗中使用HAART可恢复针对病原体的免疫反应，然而，在少数患者中，重建的免疫系统会导致IRIS。由于IRIS的治疗方案尚未标准化，这会导致短期发病，在某些情况下还会导致死亡。因此，对这些患者的治疗是一项巨大挑战，此外，关于IRIS的免疫发病机制、诊断和管理的进一步研究应经过深思熟虑。要了解IRIS的免疫发病机制，很难阐明HAART启动后免疫细胞的内在动态，但有一些生物标志物有助于在HIV治疗开始后预测或诊断IRIS并制定具体治疗方案。本综述旨在关注那些患有IRIS的患者，并为其病情进展的管理提供治疗指南。
