Vinhaes Caian L, Araujo-Pereira Mariana, Tibúrcio Rafael, Cubillos-Angulo Juan M, Demitto Fernanda O, Akrami Kevan M, Andrade Bruno B
Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil.
Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador 40210-320, Brazil.
Life (Basel). 2021 Jan 18;11(1):65. doi: 10.3390/life11010065.
Antiretroviral therapy (ART) has represented a major advancement in the care of people living with HIV (PLWHH), resulting in significant reductions in morbidity and mortality through immune reconstitution and attenuation of homeostatic disruption. Importantly, restoration of immune function in PLWH with opportunistic infections occasionally leads to an intense and uncontrolled cytokine storm following ART initiation known as immune reconstitution inflammatory syndrome (IRIS). IRIS occurrence is associated with the severe and rapid clinical deterioration that results in significant morbidity and mortality. Here, we detail the determinants underlying IRIS development in PLWH, compiling the available knowledge in the field to highlight details of the inflammatory responses in IRIS associated with the most commonly reported opportunistic pathogens. This review also highlights gaps in the understanding of IRIS pathogenesis and summarizes therapeutic strategies that have been used for IRIS.
抗逆转录病毒疗法（ART）是艾滋病毒感染者（PLWHH）护理领域的一项重大进展，通过免疫重建和减轻体内稳态破坏，显著降低了发病率和死亡率。重要的是，患有机会性感染的艾滋病毒感染者免疫功能的恢复偶尔会导致在开始抗逆转录病毒治疗后出现强烈且不受控制的细胞因子风暴，即免疫重建炎症综合征（IRIS）。IRIS的发生与严重且迅速的临床恶化相关，这会导致显著的发病率和死亡率。在此，我们详细阐述了艾滋病毒感染者发生IRIS的潜在决定因素，汇总该领域的现有知识，以突出与最常报告的机会性病原体相关的IRIS炎症反应细节。本综述还强调了对IRIS发病机制理解上的差距，并总结了已用于治疗IRIS的策略。
