The immune reconstitution inflammatory syndrome: etiology, pathogenesis, clinical manifestations
Journal Title: Туберкульоз, легеневі хвороби, ВІЛ-інфекція - Year 2019, Vol 0, Issue 1
Abstract
Increasing of HIV-infection incidence in many countries of the world and in Ukraine in particular, late identification of patients and an increase in the power of antiretroviral therapy requires the doctors to treat the immune reconstitution inflammatory syndrome. The polymorphism of its manifestations and the delay in the onset of symptoms from the start of antiretroviral therapy make it difficult to diagnose this pathological condition timely and prescribe adequate treatment. In this work, a review of the literature on the problems of the immune reconstitution inflammatory syndrome has been conducted and the characteristics of it etiology, pathogenesis and clinical manifestations have been systematized. The main causes and mechanisms of the appearance of the unmasking and paradoxical forms of the immune reconstitution inflammatory syndrome were described. The global epidemiological data on the prevalence of immune reconstitution inflammatory syndrome and mortality from it various forms were analyzed. The main variants of the immune reconstitution inflammatory syndrome, namely tuberculosis-associated immune reconstitution inflammatory syndrome, сryptococcus-associated immune reconstitution inflammatory syndrome, and immune reconstitution inflammatory syndrome associated with Kaposi’s sarcoma, are considered. The most specific lesion sites, such as the central nervous system, skin, and mucous membranes were described. The criteria for the diagnosis of the most common forms of the immune reconstitution inflammatory syndrome were summarized. The main recommendations for the treatment and prevention of the immune reconstitution inflammatory syndrome, based on the world clinical researches, as well as expert opinions on the use of certain treatment methods for various conditions associated with the immune reconstitution inflammatory syndrome were presented. The main problems and future prospects of research in this direction were identified.
Authors and Affiliations
O. S. Shevchenko, V. I. Petrenko, L. D. Todoriko, O. O. Pohorielova
Clinical case of immunoglobulin G application with сhemo-resistant tuberculosis in combination with HIV-infection with severe immunosuppression
Chemo-resistant tuberculosis in combination with HIV infection is one of the most difficult problems of modern phthisiology. Of particular interest is the contingent of patients with MDR TB/HIV with a level of CD 4 in bl...
Severe cases of tuberculosis and improving the efficiency of treatment in the application of the standard schemes
Objective — was to analyze the prevalence of severe cases of tuberculosis and the situation of comorbidity with various variants of concomitant pathology, substantiation of ways of influence for increase of efficiency of...
Extrapulmonary tuberculosis and miliary tuberculosis in patients with TB/HIV co-infection. Part 4
-
Peculiarity diagnosis of tuberculosis in HIV-infected
Objective — to analyze the spectrum and frequency of detection extrapulmonary clinical forms of tuberculosis and determinate plans of diagnosis among patients with HIV infection. Materials and methods. 55 cases of tube...
Experience in implementing results-based financing in the practice of providing services to patients with tuberculosis
Objective — to describe implementation process of the pilot project «Result based funding for DOT provision for TB patients at ambulatory treatment phase» (hereinafter — Project) in Odessa region and assess its effective...