[Human immunodeficiency virus and AIDS-associated immune reconstitution syndrome. State of the art].
Since the arrival of highly active antiretroviral therapy (HAART), immune reconstitution syndrome (IRS) has become an increasingly more frequent complication in patients with human immunodeficiency virus (HIV) infection. This article presents a review of the available evidence on this subject, indexed in MEDLINE-PUBMED, BVS-BIREME, and BioMed Central. The review covers the definition, epidemiology, classification, and diagnostic criteria related to IRS. In addition, the clinical particularities of the most frequent etiologies are described, and a proposal for a therapeutic approach is formulated. The prognosis and future implications of this syndrome in the epidemiology of some infectious illnesses in the HIV-positive population are included. Several unresolved aspects are mentioned, such as those related to the pathophysiology of the condition, use of biomarkers for the diagnosis, and the need for evidence-based therapeutic algorithms to enable standardization of treatment for these patients.
Reyes-Corcho
Andrés
A
Servicio de Enfermedades Infecciosas, Hospital Universitario Dr. Gustavo Aldereguía Lima, Cienfuegos, Cuba.
Bouza-Jiménez
Yadira
Y
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D000465:Algorithms; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001327:Autoimmune Diseases / Q000276:immunology; D016207:Cytokines / Q000502:physiology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000276:immunology / Q000503:physiopathology / Q000517:prevention & control; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D019380:Anti-HIV Agents; D000893:Anti-Inflammatory Agents; D016207:Cytokines; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha