Immune reconstitution disorders in patients with HIV infection: from pathogenesis to prevention and treatment

C. C. Chang, Virginia Sheikh, Irini Sereti, Martyn A. French

Research output: Contribution to journalReview ArticleResearch

23 Citations (Scopus)

Abstract

An immune reconstitution disorder occurs in up to 40 % of severely immunodeficient HIV patients who commence antiretroviral therapy (ART), with an immune reconstitution inflammatory syndrome (IRIS) being encountered most commonly. Differences in the immunopathogenesis of an IRIS associated with different types of pathogen have become apparent but common features have also been defined. These include severe immunodeficiency prior to commencing ART associated with a high pathogen load and 'compensatory' immune responses, particularly innate immune responses, which inadequately control the pathogen and increase the risk of immunopathology as the immune system recovers on ART. Prevention of an IRIS may be achieved by optimising therapy for opportunistic infections before ART is commenced, delaying ART or using immunomodulatory therapy to prevent or suppress the immune response that causes the immunopathology. However, further clinical studies are required to examine these options in a systematic manner for the various types of IRIS.
Original languageEnglish
Pages (from-to)223 - 232
Number of pages10
JournalCurrent HIV/AIDS Reports
Volume11
Issue number3
DOIs
Publication statusPublished - Sep 2014

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