Immune reconstitution inflammatory syndrome in HIV-positive patients: a relatively new and not fully understood phenomenon

摘要

The article describes the immune reconstitution inflammatory syndrome in HIV-positive patients as a phenomenon detected in recent years as a consequence of HAART initiation in patients with a severely compromised immune system and rapid improvement under HAART. Pathophysiology, clinical presentation and therapeutic options are discussed. Until recently, 'immune reconstitution' has been a concept rather than clinical reality. With the introduction of HAART and its effectiveness, the phenomenon 'immune reconstitution inflammatory syndrome' (IRIS) developed [1,2]. IRIS provokes atypical courses of opportunistic infections, often in the CNS, as well as inflammatory diseases of the central and peripheral nervous system. It starts from weeks to months and even years after the initiation of HAART and provokes a paradoxic deterioration after a positive response of the immune system and HIV infection to the antiretroviral medication.