title: [IRIS: a paradoxical inflammatory reaction in patients treated simultaneously for tuberculosis and HIV].
abstract: Co-infection with Mycobacterium tuberculosis (Mtb) and human immunodeficiency virus (HIV) represents a major threat to public health worldwide. The treatment of patients coinfected by Mtb and HIV is often complicated by the occurrence of an immune reconstitution inflammatory syndrome (IRIS), resulting in the unexpected resumption of tuberculosis symptoms after the initiation of antiretroviral therapy. IRIS is associated with a rapid reconstitution of CD4(+) T cell responses specific for Mtb, which is promoted by the control of HIV replication and a high concentration of available interleukin-7. Macrophages, whose activity is suddenly stimulated by CD4(+) T cell help, respond by an exacerbated inflammatory response in Mtb-rich tissues. A major research objective remains to identify biomarkers which could allow a reliable prediction of IRIS occurrence, in order to optimize medical care for the many patients affected by both HIV and tuberculosis in resource-limited settings.
authors: Unité de pathogénie virale, Inserm U1108, Institut Pasteur, 28, rue du Docteur Roux, 75724 Paris Cedex 15, France.
authors: Lisa A
authors: LA
authors: Chakrabarti
authors: Université Paris Descartes, hôpital Necker-Enfants malades, centre d'infectiologie Necker Pasteur, IHU Imagine, AP-HP, Paris, France.
authors: Olivier
authors: O
authors: Lortholary
mesh_terms: D060085:Coinfection; D015658:HIV Infections / Q000150:complications / Q000276:immunology / Q000628:therapy*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D007249:Inflammation / Q000209:etiology / Q000276:immunology; D012307:Risk Factors; D014376:Tuberculosis / Q000150:complications / Q000276:immunology / Q000628:therapy*