Immune reconstitution disorders in HIV patients receiving antiretroviral therapy
Martyn A FrenchSchool of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
Department of Clinical Immunology, Royal Perth Hospital and PathWest Laboratory Medicine, Perth, WA, Australia
Email: martyn.french@uwa.edu.au
Microbiology Australia 35(2) 97-98 https://doi.org/10.1071/MA14030
Published: 16 April 2014
Abstract
Suppression of HIV infection by antiretroviral therapy (ART) resolves much of the immune dysfunction caused by HIV replication. However, reconstitution of the immune system during ART may, paradoxically, cause immunological disease that presents clinically as an immune reconstitution disorder. These disorders include autoimmune disease, mainly Graves' disease, and immune-mediated inflammatory disease, such as sarcoidosis. However, by far the most common type of immune reconstitution disorder results from restoring immune responses against opportunistic pathogens.
References
[1] French, M.A. (2012) Immune reconstitution inflammatory syndrome: immune restoration disease 20 years on. Med. J. Aust. 196, 318–321.| Immune reconstitution inflammatory syndrome: immune restoration disease 20 years on.Crossref | GoogleScholarGoogle Scholar | 22432669PubMed |
[2] Barber, D.L. et al. (2014) Role of IL-6 in Mycobacterium avium-associated immune reconstitution inflammatory syndrome. J. Immunol. , .
| Role of IL-6 in Mycobacterium avium-associated immune reconstitution inflammatory syndrome.Crossref | GoogleScholarGoogle Scholar | 24591367PubMed |
[3] Oliver, B.G. et al. (2010) Mediators of innate and adaptive immune responses differentially affect immune restoration disease associated with Mycobacterium tuberculosis in HIV patients beginning ART. J. Infect. Dis. 202, 1728–1737.
| Mediators of innate and adaptive immune responses differentially affect immune restoration disease associated with Mycobacterium tuberculosis in HIV patients beginning ART.Crossref | GoogleScholarGoogle Scholar | 20977362PubMed |
[4] Chang, C. et al. (2013) Chemokine levels and chemokine receptor expression in blood and the CSF of HIV-infected patients with cryptococcal meningitis and C-IRIS. J. Infect. Dis. 208, 1604–1612.
| Chemokine levels and chemokine receptor expression in blood and the CSF of HIV-infected patients with cryptococcal meningitis and C-IRIS.Crossref | GoogleScholarGoogle Scholar | 23908492PubMed |
[5] Vignesh, R. et al. (2013) TB-IRIS after initiation of antiretroviral therapy is associated with expansion of preexistent Th1 responses against Mycobacterium tuberculosis antigens. J. Acquir. Immune Defic. Syndr. 64, 241–248.
| TB-IRIS after initiation of antiretroviral therapy is associated with expansion of preexistent Th1 responses against Mycobacterium tuberculosis antigens.Crossref | GoogleScholarGoogle Scholar | 23774879PubMed |
[6] Chang, C.C. et al. (2013) Cryptococcosis-IRIS is associated with lower Cryptococcus-specific IFN-gamma responses before antiretroviral therapy but not higher T-cell responses during therapy. J. Infect. Dis. 208, 898–906.
| Cryptococcosis-IRIS is associated with lower Cryptococcus-specific IFN-gamma responses before antiretroviral therapy but not higher T-cell responses during therapy.Crossref | GoogleScholarGoogle Scholar | 23766525PubMed |
[7] Oliver, B.G. et al. (2012) Tuberculosis after commencing antiretroviral therapy for HIV infection is associated with elevated CXCL9 and CXCL10 responses to Mycobacterium tuberculosis antigens. J. Acquir. Immune Defic. Syndr. 61, 287–292.
| Tuberculosis after commencing antiretroviral therapy for HIV infection is associated with elevated CXCL9 and CXCL10 responses to Mycobacterium tuberculosis antigens.Crossref | GoogleScholarGoogle Scholar | 22732467PubMed |
[8] Seddiki, N. et al. (2009) Proliferation of weakly suppressive regulatory CD4+ T cells is associated with over-active CD4+ T-cell responses in HIV-positive patients with mycobacterial immune restoration disease. Eur. J. Immunol. 39, 391–403.
| Proliferation of weakly suppressive regulatory CD4+ T cells is associated with over-active CD4+ T-cell responses in HIV-positive patients with mycobacterial immune restoration disease.Crossref | GoogleScholarGoogle Scholar | 19180462PubMed |
[9] Chang, C.C. et al. (2013) Clinical and mycological predictors of Cryptococcosis-associated immune reconstitution inflammatory syndrome. AIDS 27, 2089–2099.
| Clinical and mycological predictors of Cryptococcosis-associated immune reconstitution inflammatory syndrome.Crossref | GoogleScholarGoogle Scholar | 23525034PubMed |