The immunopathogenesis of the HIV tuberculosis immune reconstitution inflammatory syndrome

R.P. Lai, J.K. Nakiwala, G. Meintjes, R.J. Wilkinson

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    HIV-1 patients co-infected with some pathogens are at risk of developing the immune reconstitution inflammatory syndrome (IRIS) when initiating antiretroviral therapy (ART). IRIS is characterized by inflammation leading to the clinical worsening of a treated infection or the unmasking of a previously undiagnosed condition or infection. It is commonly associated with tuberculosis (TB), 8-43% of the HIV-TB co-infected patients prescribed with antitubercular treatment and ART develop TB-IRIS. Although IRIS has been recognized for over 20 years, relatively little was known until recently about its pathogenesis. Despite these advances in understanding IRIS, there remains no immune biomarker for diagnostic or prognostic purposes. Here, we review the risk factors associated with TB-IRIS, the challenges in studying this syndrome, and how T lymphocytes, dysregulated cytokine responses, and innate immunity may contribute to the development of TB-IRIS.
    Original languageEnglish
    JournalEuropean Journal of Immunology
    Issue number8
    Pages (from-to)1995-2002
    Number of pages8
    Publication statusPublished - 2013

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