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Tuberculosis-immune reconstitution inflammatory syndrome.

Authors
  • Lanzafame, Massimiliano1
  • Vento, Sandro2
  • 1 Infectious Diseases Unit, "G.B. Rossi" University Hospital, Verona, Italy. , (Italy)
  • 2 Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan. , (Kazakhstan)
Type
Published Article
Journal
Journal of clinical tuberculosis and other mycobacterial diseases
Publication Date
May 01, 2016
Volume
3
Pages
6–9
Identifiers
DOI: 10.1016/j.jctube.2016.03.002
PMID: 31723680
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Tuberculosis-immune reconstitution inflammatory syndrome is an excessive immune response against Mycobacterium tuberculosis that may occur in either HIV-infected or uninfected patients, during or after completion of anti-TB therapy. In HIV-infected patients it occurs after initiation of antiretroviral therapy independently from an effective suppression of HIV viremia. There are two forms of IRIS: paradoxical or unmasking. Paradoxical IRIS is characterized by recurrent, new, or worsening symptoms of a treated case. Unmasking IRIS is an antiretroviral-associated inflammatory manifestation of a subclinical infection with a hastened presentation. The pathogenesis is incompletely understood and the epidemiology partially described. No specific tests can establish or rule out the diagnosis. Treatment is based on the use of anti-tuberculosis drugs sometime with adjunctive corticosteroids. Mortality is generally low. © 2016 Published by Elsevier Ltd.

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