Immune Reconstitution Inflammatory Syndrome
AIDS-Related Opportunistic Infections
Antiretroviral Therapy, Highly Active
Meningitis, Cryptococcal
HIV Infections
Leukoencephalopathy, Progressive Multifocal
Tuberculosis
Central Nervous System Bacterial Infections
CD4 Lymphocyte Count
Anti-HIV Agents
Immune System Diseases
Antitubercular Agents
Tuberculosis, Central Nervous System
JC Virus
South Africa
Viral Load
HIV-1
Acquired Immunodeficiency Syndrome
Mycobacterium tuberculosis
CD4-Positive T-Lymphocytes
Inflammation
Prospective Studies
Cohort Studies
Survival of HIV-infected patients in the intensive care unit in the era of highly active antiretroviral therapy. (1/173)
BACKGROUND: Several studies have described improved outcomes for HIV-infected patients admitted to the intensive care unit (ICU) since the introduction of highly active antiretroviral therapy (HAART). A study was undertaken to examine the outcome from the ICU for HIV-infected patients and to identify prognostic factors. METHODS: A retrospective study of HIV-infected adults admitted to a university affiliated hospital ICU between January 1999 and December 2005 was performed. Information was collected on patient demographics, receipt of HAART (no patient began HAART on the ICU), reason for ICU admission and hospital course. Outcomes were survival to ICU discharge and to hospital discharge. RESULTS: 102 patients had 113 admissions to the ICU; HIV infection was newly diagnosed in 31 patients. Survival (first episode ICU discharge and hospital discharge) was 77% and 68%, respectively, compared with 74% and 65% for general medical patients. ICU and hospital survival was 78% and 67% in those receiving HAART, and 75% and 66% in those who were not. In univariate analysis, factors associated with survival were: haemoglobin (OR = 1.25, 95% CI 1.03 to 1.51, for an increase of 1 g/dl), CD4 count (OR = 1.59, 95% CI 0.98 to 2.58, for a 10-fold increase in cells/microl), APACHE II score (OR = 0.51, 95% CI 0.29 to 0.90, for a 10 unit increase) and mechanical ventilation (OR = 0.29, 95% CI 0.10 to 0.83). CONCLUSIONS: The outcome for HIV-infected patients admitted to the ICU was good and was comparable to that in general medical patients. More than a quarter of patients had newly diagnosed HIV infection. Patients receiving HAART did not have a better outcome. (+info)Cellulitis revealing a cryptococcosis-related immune reconstitution inflammatory syndrome in a renal allograft recipient. (2/173)
Immune reconstitution inflammatory syndrome (IRIS) has rarely been described in the course of disseminated cryptococcosis in solid organ transplant recipients. We report here the case of a renal transplant recipient who developed severe cellulitis in the context of Cryptococcus neoformans-associated IRIS while undergoing reduction of his immunosuppressive therapy. IRIS appeared concomitantly with a dramatic increase of blood CD4+ T cells (94-460/mm(3)) and required the administration of a short-term steroid therapy to resolve. (+info)Immune reconstitution syndrome in patients treated for HIV and tuberculosis in Rio de Janeiro. (3/173)
We made a retrospective longitudinal study from January 2000 to January 2003 to examine cases of immune reconstitution syndrome (IRS) and its incidence rate in tuberculosis (TB)-human immunodeficiency virus (HIV) co-infected patients. The incidence rate (IR) was calculated using a Poisson regression. The confidence interval (CI) that was stipulated was 95%. IRS occurred in 10/84 HIV and TB-positive patients; nine of them were on highly active anti-retroviral therapy (HAART) during a mean of 61.7 (+/- 59) days following the introduction of antiretrovirals. Lymph-node enlargement was the sole clinical manifestation. CD4 counts were <100 cells/mm(3)in 50% of the patients, at the time of TB diagnosis. All but two patients were treated with prednisone, and recovered from TB within a mean of 91 days (+/- 30 days). One relapse of TB was observed, but there were no IRS-related deaths. The incidence rate was higher (IR=11.18; CI, 1.41-88.76) in patients that had superficial lymph node enlargement at the moment of TB diagnosis (not associated with TB), extrapulmonary TB (IR=1.97; CI, 0.44-8.79), were antiretroviral naive (IR=1.85; CI, 0.48-7.16), and CD4 counts <100 cells/mm(3) (IR=1.50; CI, 0.40-5.59), although with a wide CI. IRS was frequent in our sample, occurred more frequently in HIV-naive patients with lymph-node enlargement and extrapulmonary TB. No cases of new pulmonary lesions or worsening of pulmonary infiltrates were observed. (+info)A patient with de novo tuberculosis during anti-tumor necrosis factor-alpha therapy illustrating diagnostic pitfalls and paradoxical response to treatment. (4/173)
In 2005, a 24-year-old man with Crohn disease who had been treated with infliximab for several months was exposed to an individual with smear-positive tuberculosis. Soon after exposure, he complained of malaise, dry cough, and weight loss. Despite normal chest radiograph findings and negative tuberculin skin test results, tuberculosis was considered to be the most likely diagnosis. The results of a whole-blood assay for detection of interferon- gamma production in response to Mycobacterium tuberculosis-specific antigen were positive. Acid-fast staining and polymerase chain reaction of bronchoalveolar lavage fluid samples had negative results, but M. tuberculosis was cultured. After the initiation of 4 antitubercular drugs and the discontinuation of infliximab therapy, the patient developed an immune reconstitution syndrome accompanied by enlarged mediastinal lymph nodes and multiple intrapulmonary miliary lesions. This case of de novo tuberculosis during anti-tumor necrosis factor alpha treatment illustrates the uncharacteristic presentation of the disease and the elusiveness of the diagnosis, as well as the fact that discontinuation of anti-tumor necrosis factor alpha treatment can be accompanied by an immune reconstitution syndrome similar to that observed in human immunodeficiency virus-infected individuals with tuberculosis. (+info)Liver enzymes elevation and immune reconstitution among treatment-naive HIV-infected patients instituting antiretroviral therapy. (5/173)
OBJECTIVES: Because liver enzymes elevation (LEE) complicates antiretroviral (ARV) therapy, and because the strongest risk factor for ARV-related LEE is HBV/HCV coinfection, it is speculated that ARV-related LEE may be a form of immune reconstitution disease. This study summarizes the relation between immune reconstitution, ARV-induced LEE, and HBV/HCV coinfection. METHODS: Medical records of ARV-naive HIV-infected patients initiating ARV were reviewed for hepatitis coinfection, LEE (grade > or =2 AST/ALT) and changes in CD4 T-cell counts over time in an urban HIV clinic. Risk factors for LEE were statistically evaluated, and changes in CD4 T-cell counts were estimated by a mixed-effects linear model. RESULTS: Predictors of LEE included HBV/HCV coinfection (OR = 6.44) and stavudine use (OR = 2.33). Nelfinavir use was protective (OR = 0.45). The mean rate of change in CD4 T-cell counts was higher in HBV/HCV coinfected subjects who developed LEE (99 cells/microL per month) compared with non-coinfected subjects who did not develop LEE (59 cells/microL per month, P = 0.03), non-coinfected subjects who developed LEE (36 cells/microL per month, P =0.01), and coinfected subjects who did not develop LEE, 38% higher (62 cells/microL per month; P =0.11) CONCLUSIONS: A more robust immune restoration was observed among HBV/HCV coinfected subjects who developed liver enzyme elevation after antiretroviral initiation compared with other groups. This finding suggests that ARV-related liver enzyme elevation may be related in part to immune reconstitution, as measured by changes in CD4 T-cell counts. (+info)Immune reconstitution inflammatory syndrome in a patient with cryptococcal lymphadenitis as the first presentation of acquired immunodeficiency syndrome. (6/173)
Immune reconstitution inflammatory syndrome is commonly seen in acquired immunodeficiency syndrome (AIDS) patients having concomitant opportunistic infection, following initiation of highly active anti-retroviral therapy (HAART). We describe IRIS in a young man with unknown human immunodeficiency virus (HIV) status who presented with cryptococcal lymphadenitis as the first manifestation of AIDS. At presentation the patient had features overlapping with tuberculosis (TB) lymphadenitis which was ruled out by fine needle aspiration cytology. The patient responded to antifungal treatment but following the start of HAART, symptoms recurred which were managed conservatively. Though TB is common in India, a thorough workup including histopathology of lymph node should be done before the patient is started on anti-tuberculosis treatment. HIV infected patients having opportunistic co-infection should be closely monitored following initiation of HAART. (+info)De novo autoimmune hepatitis during immune reconstitution in an HIV-infected patient receiving highly active antiretroviral therapy. (7/173)
(+info)Acute cytomegalovirus colitis presenting during primary HIV infection: an unusual case of an immune reconstitution inflammatory syndrome. (8/173)
(+info)Immune Reconstitution Inflammatory Syndrome (IRIS) is not a disease itself, but rather a reaction that can occur in some individuals who have a weakened immune system and then receive treatment to restore their immune function.
IRIS is defined as a paradoxical clinical worsening or appearance of new symptoms following the initiation of antiretroviral therapy (ART) in HIV-infected patients, or after the administration of other immunomodulatory agents in patients with other types of immune deficiency.
This reaction is thought to be due to an overactive immune response to opportunistic infections or malignancies that were present but not causing symptoms while the patient's immune system was severely compromised. As the immune system begins to recover, it may mount a strong inflammatory response to these underlying infections or cancers, leading to worsening of symptoms or the development of new ones.
IRIS can affect various organs and systems, causing a wide range of clinical manifestations. The most common opportunistic infections associated with IRIS include Mycobacterium avium complex (MAC), Cytomegalovirus (CMV), Pneumocystis jirovecii pneumonia (PJP), and Cryptococcus neoformans.
The management of IRIS involves a careful balance between continuing the immune-restoring therapy and providing appropriate treatment for the underlying infection or malignancy, while also managing the inflammatory response with anti-inflammatory medications if necessary.
AIDS-related opportunistic infections (AROIs) are infections that occur more frequently or are more severe in people with weakened immune systems, such as those with advanced HIV infection or AIDS. These infections take advantage of a weakened immune system and can affect various organs and systems in the body.
Common examples of AROIs include:
1. Pneumocystis pneumonia (PCP), caused by the fungus Pneumocystis jirovecii
2. Mycobacterium avium complex (MAC) infection, caused by a type of bacteria called mycobacteria
3. Candidiasis, a fungal infection that can affect various parts of the body, including the mouth, esophagus, and genitals
4. Toxoplasmosis, caused by the parasite Toxoplasma gondii
5. Cryptococcosis, a fungal infection that affects the lungs and central nervous system
6. Cytomegalovirus (CMV) infection, caused by a type of herpes virus
7. Tuberculosis (TB), caused by the bacterium Mycobacterium tuberculosis
8. Cryptosporidiosis, a parasitic infection that affects the intestines
9. Progressive multifocal leukoencephalopathy (PML), a viral infection that affects the brain
Preventing and treating AROIs is an important part of managing HIV/AIDS, as they can cause significant illness and even death in people with weakened immune systems. Antiretroviral therapy (ART) is used to treat HIV infection and prevent the progression of HIV to AIDS, which can help reduce the risk of opportunistic infections. In addition, medications to prevent specific opportunistic infections may be prescribed for people with advanced HIV or AIDS.
Antiretroviral Therapy, Highly Active (HAART) is a medical treatment regimen used to manage HIV infection. It involves the combination of three or more antiretroviral drugs from at least two different classes, aiming to maximally suppress viral replication and prevent the development of drug resistance. The goal of HAART is to reduce the amount of HIV in the body to undetectable levels, preserve immune function, and improve quality of life for people living with HIV. Commonly used antiretroviral classes include nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), integrase strand transfer inhibitors (INSTIs), and fusion inhibitors.
Cryptococcal meningitis is a specific type of meningitis, which is an inflammation of the membranes covering the brain and spinal cord, known as the meninges. This condition is caused by the fungus Cryptococcus neoformans or Cryptococcus gattii.
In cryptococcal meningitis, the fungal cells enter the bloodstream and cross the blood-brain barrier, causing infection in the central nervous system. The immune system's response to the infection leads to inflammation of the meninges, resulting in symptoms such as headache, fever, neck stiffness, altered mental status, and sometimes seizures or focal neurological deficits.
Cryptococcal meningitis is a serious infection that can be life-threatening if left untreated. It primarily affects people with weakened immune systems, such as those with HIV/AIDS, organ transplant recipients, and individuals receiving immunosuppressive therapy for cancer or autoimmune diseases. Early diagnosis and appropriate antifungal treatment are crucial to improve outcomes in patients with cryptococcal meningitis.
Anti-retroviral agents are a class of drugs used to treat and prevent infections caused by retroviruses, most commonly the human immunodeficiency virus (HIV). These medications work by interfering with the replication process of the retrovirus, thereby preventing it from infecting and destroying immune cells.
There are several different classes of anti-retroviral agents, including:
1. Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) - These drugs block the action of the reverse transcriptase enzyme, which is necessary for the retrovirus to convert its RNA into DNA.
2. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) - These drugs bind directly to the reverse transcriptase enzyme and alter its shape, preventing it from functioning properly.
3. Protease inhibitors (PIs) - These drugs block the action of the protease enzyme, which is necessary for the retrovirus to assemble new viral particles.
4. Integrase inhibitors (INIs) - These drugs block the action of the integrase enzyme, which is necessary for the retrovirus to integrate its DNA into the host cell's genome.
5. Fusion inhibitors - These drugs prevent the retrovirus from entering host cells by blocking the fusion of the viral and host cell membranes.
6. Entry inhibitors - These drugs prevent the retrovirus from attaching to and entering host cells.
Anti-retroviral therapy (ART) typically involves a combination of at least three different anti-retroviral agents from two or more classes, in order to effectively suppress viral replication and prevent drug resistance. Regular monitoring of viral load and CD4+ T cell counts is necessary to ensure the effectiveness of ART and make any necessary adjustments to the treatment regimen.
HIV (Human Immunodeficiency Virus) infection is a viral illness that progressively attacks and weakens the immune system, making individuals more susceptible to other infections and diseases. The virus primarily infects CD4+ T cells, a type of white blood cell essential for fighting off infections. Over time, as the number of these immune cells declines, the body becomes increasingly vulnerable to opportunistic infections and cancers.
HIV infection has three stages:
1. Acute HIV infection: This is the initial stage that occurs within 2-4 weeks after exposure to the virus. During this period, individuals may experience flu-like symptoms such as fever, fatigue, rash, swollen glands, and muscle aches. The virus replicates rapidly, and the viral load in the body is very high.
2. Chronic HIV infection (Clinical latency): This stage follows the acute infection and can last several years if left untreated. Although individuals may not show any symptoms during this phase, the virus continues to replicate at low levels, and the immune system gradually weakens. The viral load remains relatively stable, but the number of CD4+ T cells declines over time.
3. AIDS (Acquired Immunodeficiency Syndrome): This is the most advanced stage of HIV infection, characterized by a severely damaged immune system and numerous opportunistic infections or cancers. At this stage, the CD4+ T cell count drops below 200 cells/mm3 of blood.
It's important to note that with proper antiretroviral therapy (ART), individuals with HIV infection can effectively manage the virus, maintain a healthy immune system, and significantly reduce the risk of transmission to others. Early diagnosis and treatment are crucial for improving long-term health outcomes and reducing the spread of HIV.
A syndrome, in medical terms, is a set of symptoms that collectively indicate or characterize a disease, disorder, or underlying pathological process. It's essentially a collection of signs and/or symptoms that frequently occur together and can suggest a particular cause or condition, even though the exact physiological mechanisms might not be fully understood.
For example, Down syndrome is characterized by specific physical features, cognitive delays, and other developmental issues resulting from an extra copy of chromosome 21. Similarly, metabolic syndromes like diabetes mellitus type 2 involve a group of risk factors such as obesity, high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that collectively increase the risk of heart disease, stroke, and diabetes.
It's important to note that a syndrome is not a specific diagnosis; rather, it's a pattern of symptoms that can help guide further diagnostic evaluation and management.
Progressive multifocal leukoencephalopathy (PML) is a rare and serious demyelinating disease of the central nervous system that affects the white matter of the brain. It's caused by the reactivation of the John Cunningham virus (JCV) in immunocompromised individuals, such as those with HIV/AIDS, organ transplants, or hematologic malignancies.
In PML, the JCV infects and destroys the oligodendrocytes, which are the cells responsible for producing myelin, the fatty substance that insulates and protects nerve fibers. This results in multiple areas of focal demyelination throughout the brain, leading to progressive neurological symptoms such as cognitive decline, motor weakness, vision loss, and speech difficulties.
PML is a medical emergency, and prompt diagnosis and treatment of the underlying immunodeficiency are crucial for improving outcomes. Unfortunately, there is no specific treatment for PML itself, but restoring immune function can help slow or stop the progression of the disease.
Tuberculosis (TB) is a chronic infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can also involve other organs and tissues in the body. The infection is usually spread through the air when an infected person coughs, sneezes, or talks.
The symptoms of pulmonary TB include persistent cough, chest pain, coughing up blood, fatigue, fever, night sweats, and weight loss. Diagnosis typically involves a combination of medical history, physical examination, chest X-ray, and microbiological tests such as sputum smear microscopy and culture. In some cases, molecular tests like polymerase chain reaction (PCR) may be used for rapid diagnosis.
Treatment usually consists of a standard six-month course of multiple antibiotics, including isoniazid, rifampin, ethambutol, and pyrazinamide. In some cases, longer treatment durations or different drug regimens might be necessary due to drug resistance or other factors. Preventive measures include vaccination with the Bacillus Calmette-Guérin (BCG) vaccine and early detection and treatment of infected individuals to prevent transmission.
Central nervous system (CNS) bacterial infections refer to the invasion and infection of the brain or spinal cord by bacteria. This can lead to serious consequences as the CNS is highly sensitive to inflammation and infection. Examples of CNS bacterial infections include:
1. Meningitis: an infection of the meninges, the protective membranes covering the brain and spinal cord. It is often caused by bacteria such as Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae.
2. Encephalitis: an inflammation of the brain parenchyma, which can be caused by bacterial infections such as Listeria monocytogenes, Mycoplasma pneumoniae, or Bartonella henselae.
3. Brain abscess: a localized collection of pus within the brain tissue, usually resulting from direct spread of bacteria from a nearby infection, or from bacteremia (bacteria in the bloodstream). Common causes include Staphylococcus aureus, Streptococcus species, and anaerobic bacteria.
4. Spinal epidural abscess: an accumulation of pus in the epidural space surrounding the spinal cord, which can lead to compression of the spinal cord and result in serious neurological deficits. Common causative organisms include Staphylococcus aureus and other streptococci.
5. Subdural empyema: an infection in the potential space between the dura mater and the arachnoid membrane, usually caused by direct spread of bacteria from a nearby focus of infection or from bacteremia. Streptococcus species and anaerobic bacteria are common causes.
Treatment for CNS bacterial infections typically involves antibiotics, supportive care, and sometimes surgical intervention to drain abscesses or remove infected tissue. The prognosis depends on the specific infection, the patient's overall health, and how quickly treatment is initiated.
A CD4 lymphocyte count is a laboratory test that measures the number of CD4 T-cells (also known as CD4+ T-cells or helper T-cells) in a sample of blood. CD4 cells are a type of white blood cell that plays a crucial role in the body's immune response, particularly in fighting off infections caused by viruses and other pathogens.
CD4 cells express a protein on their surface called the CD4 receptor, which is used by human immunodeficiency virus (HIV) to infect and destroy these cells. As a result, people with HIV infection or AIDS often have low CD4 lymphocyte counts, which can make them more susceptible to opportunistic infections and other complications.
A normal CD4 lymphocyte count ranges from 500 to 1,200 cells per cubic millimeter of blood (cells/mm3) in healthy adults. A lower than normal CD4 count is often used as a marker for the progression of HIV infection and the development of AIDS. CD4 counts are typically monitored over time to assess the effectiveness of antiretroviral therapy (ART) and to guide clinical decision-making regarding the need for additional interventions, such as prophylaxis against opportunistic infections.
Lymphadenitis is a medical term that refers to the inflammation of one or more lymph nodes, which are small, bean-shaped glands that are part of the body's immune system. Lymph nodes contain white blood cells called lymphocytes, which help fight infection and disease.
Lymphadenitis can occur as a result of an infection in the area near the affected lymph node or as a result of a systemic infection that has spread through the bloodstream. The inflammation causes the lymph node to become swollen, tender, and sometimes painful to the touch.
The symptoms of lymphadenitis may include fever, fatigue, and redness or warmth in the area around the affected lymph node. In some cases, the overlying skin may also appear red and inflamed. Lymphadenitis can occur in any part of the body where there are lymph nodes, including the neck, armpits, groin, and abdomen.
The underlying cause of lymphadenitis must be diagnosed and treated promptly to prevent complications such as the spread of infection or the formation of an abscess. Treatment may include antibiotics, pain relievers, and warm compresses to help reduce swelling and discomfort.
Anti-HIV agents are a class of medications specifically designed to treat HIV (Human Immunodeficiency Virus) infection. These drugs work by interfering with various stages of the HIV replication cycle, preventing the virus from infecting and killing CD4+ T cells, which are crucial for maintaining a healthy immune system.
There are several classes of anti-HIV agents, including:
1. Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs): These drugs act as faulty building blocks that the virus incorporates into its genetic material, causing the replication process to halt. Examples include zidovudine (AZT), lamivudine (3TC), and tenofovir.
2. Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs): These medications bind directly to the reverse transcriptase enzyme, altering its shape and preventing it from functioning properly. Examples include efavirenz, nevirapine, and rilpivirine.
3. Protease Inhibitors (PIs): These drugs target the protease enzyme, which is responsible for cleaving viral polyproteins into functional components. By inhibiting this enzyme, PIs prevent the formation of mature, infectious virus particles. Examples include atazanavir, darunavir, and lopinavir.
4. Integrase Strand Transfer Inhibitors (INSTIs): These medications block the integrase enzyme, which is responsible for inserting the viral genetic material into the host cell's DNA. By inhibiting this step, INSTIs prevent the virus from establishing a permanent infection within the host cell. Examples include raltegravir, dolutegravir, and bictegravir.
5. Fusion/Entry Inhibitors: These drugs target different steps of the viral entry process, preventing HIV from infecting CD4+ T cells. Examples include enfuvirtide (T-20), maraviroc, and ibalizumab.
6. Post-Attachment Inhibitors: This class of medications prevents the virus from attaching to the host cell's receptors, thereby inhibiting infection. Currently, there is only one approved post-attachment inhibitor, fostemsavir.
Combination therapy using multiple classes of antiretroviral drugs has been shown to effectively suppress viral replication and improve clinical outcomes in people living with HIV. Regular adherence to the prescribed treatment regimen is crucial for maintaining an undetectable viral load and reducing the risk of transmission.
Immune system diseases, also known as immunological disorders or autoimmune diseases, refer to a group of conditions in which the immune system mistakenly attacks and damages healthy tissues in the body. The immune system is designed to protect the body from harmful substances such as viruses, bacteria, and toxins. However, in immune system diseases, the immune system fails to distinguish between these harmful substances and the body's own cells, leading to an overactive or misdirected response.
There are several types of immune system diseases, including:
1. Allergies: An abnormal immune response to harmless substances such as pollen, dust mites, or certain foods.
2. Autoimmune disorders: A group of conditions in which the immune system attacks healthy tissues, such as rheumatoid arthritis, lupus, and multiple sclerosis.
3. Immunodeficiency disorders: Conditions that weaken the immune system, making it harder for the body to fight off infections, such as HIV/AIDS or primary immunodeficiency diseases.
4. Autoinflammatory disorders: A group of conditions characterized by recurrent episodes of inflammation due to abnormal activation of the immune system, such as familial Mediterranean fever and cryopyrin-associated periodic syndromes.
5. Transplant rejection: A response in which the immune system attacks and rejects transplanted organs or tissues.
Immune system diseases can cause a wide range of symptoms, depending on the specific condition and the severity of the disease. Treatment may involve medications to suppress the immune system, as well as other therapies to manage symptoms and prevent complications.
Antitubercular agents, also known as anti-tuberculosis drugs or simply TB drugs, are a category of medications specifically used for the treatment and prevention of tuberculosis (TB), a bacterial infection caused by Mycobacterium tuberculosis. These drugs target various stages of the bacteria's growth and replication process to eradicate it from the body or prevent its spread.
There are several first-line antitubercular agents, including:
1. Isoniazid (INH): This is a bactericidal drug that inhibits the synthesis of mycolic acids, essential components of the mycobacterial cell wall. It is primarily active against actively growing bacilli.
2. Rifampin (RIF) or Rifampicin: A bactericidal drug that inhibits DNA-dependent RNA polymerase, preventing the transcription of genetic information into mRNA. This results in the interruption of protein synthesis and ultimately leads to the death of the bacteria.
3. Ethambutol (EMB): A bacteriostatic drug that inhibits the arabinosyl transferase enzyme, which is responsible for the synthesis of arabinan, a crucial component of the mycobacterial cell wall. It is primarily active against actively growing bacilli.
4. Pyrazinamide (PZA): A bactericidal drug that inhibits the synthesis of fatty acids and mycolic acids in the mycobacterial cell wall, particularly under acidic conditions. PZA is most effective during the initial phase of treatment when the bacteria are in a dormant or slow-growing state.
These first-line antitubercular agents are often used together in a combination therapy to ensure complete eradication of the bacteria and prevent the development of drug-resistant strains. Treatment duration typically lasts for at least six months, with the initial phase consisting of daily doses of INH, RIF, EMB, and PZA for two months, followed by a continuation phase of INH and RIF for four months.
Second-line antitubercular agents are used when patients have drug-resistant TB or cannot tolerate first-line drugs. These include drugs like aminoglycosides (e.g., streptomycin, amikacin), fluoroquinolones (e.g., ofloxacin, moxifloxacin), and injectable bacteriostatic agents (e.g., capreomycin, ethionamide).
It is essential to closely monitor patients undergoing antitubercular therapy for potential side effects and ensure adherence to the treatment regimen to achieve optimal outcomes and prevent the development of drug-resistant strains.
Central Nervous System (CNS) Tuberculosis is a specific form of tuberculosis (TB) that refers to the infection and inflammation caused by Mycobacterium tuberculosis in the brain or spinal cord. The two most common forms of CNS tuberculosis are tuberculous meningitis and tuberculomas.
1. Tuberculous Meningitis (TBM): This is the most frequent form of CNS TB, characterized by the inflammation of the membranes surrounding the brain and spinal cord (meninges). The infection can lead to the formation of caseous lesions (granulomas), which may obstruct cerebrospinal fluid (CSF) flow and result in increased intracranial pressure. Symptoms often include headache, fever, altered mental status, neck stiffness, vomiting, and focal neurological deficits.
2. Tuberculomas: These are localized granulomatous lesions formed by the immune response to M. tuberculosis in the brain parenchyma. They can cause various neurological symptoms depending on their size and location, such as seizures, focal deficits, or increased intracranial pressure.
CNS TB is a severe manifestation of tuberculosis that requires prompt diagnosis and treatment to prevent long-term neurological damage or even death. Diagnosis typically involves imaging studies (CT or MRI scans) and analysis of cerebrospinal fluid obtained through lumbar puncture. Treatment usually consists of a prolonged course of multiple antituberculous drugs, along with corticosteroids to manage inflammation and prevent complications.
The JC (John Cunningham) virus, also known as human polyomavirus 2 (HPyV-2), is a type of double-stranded DNA virus that belongs to the Polyomaviridae family. It is named after the initials of the patient in whom it was first identified.
JC virus is a ubiquitous virus, meaning that it is commonly found in the general population worldwide. Most people get infected with JC virus during childhood and do not experience any symptoms. After the initial infection, the virus remains dormant in the kidneys and other organs of the body.
However, in individuals with weakened immune systems, such as those with HIV/AIDS or who have undergone organ transplantation, JC virus can reactivate and cause a serious brain infection called progressive multifocal leukoencephalopathy (PML). PML is a rare but often fatal disease that affects the white matter of the brain, causing cognitive decline, weakness, and paralysis.
There is currently no cure for PML, and treatment is focused on managing the underlying immune deficiency and controlling the symptoms of the disease.
I'm sorry for any confusion, but "South Africa" is not a medical term or concept. It is a country located at the southernmost tip of the African continent. If you have any questions related to medical topics, I would be happy to help answer them!
Cryptococcosis is a fungal infection caused by the yeast-like fungus Cryptococcus neoformans or Cryptococcus gattii. It can affect people with weakened immune systems, such as those with HIV/AIDS, cancer, organ transplants, or long-term steroid use. The infection typically starts in the lungs and can spread to other parts of the body, including the brain (meningitis), causing various symptoms like cough, fever, chest pain, headache, confusion, and vision problems. Treatment usually involves antifungal medications, and the prognosis depends on the patient's immune status and the severity of the infection.
Viral load refers to the amount or quantity of virus (like HIV, Hepatitis C, SARS-CoV-2) present in an individual's blood or bodily fluids. It is often expressed as the number of virus copies per milliliter of blood or fluid. Monitoring viral load is important in managing and treating certain viral infections, as a higher viral load may indicate increased infectivity, disease progression, or response to treatment.
HIV-1 (Human Immunodeficiency Virus type 1) is a species of the retrovirus genus that causes acquired immunodeficiency syndrome (AIDS). It is primarily transmitted through sexual contact, exposure to infected blood or blood products, and from mother to child during pregnancy, childbirth, or breastfeeding. HIV-1 infects vital cells in the human immune system, such as CD4+ T cells, macrophages, and dendritic cells, leading to a decline in their numbers and weakening of the immune response over time. This results in the individual becoming susceptible to various opportunistic infections and cancers that ultimately cause death if left untreated. HIV-1 is the most prevalent form of HIV worldwide and has been identified as the causative agent of the global AIDS pandemic.
Acquired Immunodeficiency Syndrome (AIDS) is a chronic, life-threatening condition caused by the Human Immunodeficiency Virus (HIV). AIDS is the most advanced stage of HIV infection, characterized by the significant weakening of the immune system, making the person more susceptible to various opportunistic infections and cancers.
The medical definition of AIDS includes specific criteria based on CD4+ T-cell count or the presence of certain opportunistic infections and diseases. According to the Centers for Disease Control and Prevention (CDC), a person with HIV is diagnosed with AIDS when:
1. The CD4+ T-cell count falls below 200 cells per cubic millimeter of blood (mm3) - a normal range is typically between 500 and 1,600 cells/mm3.
2. They develop one or more opportunistic infections or cancers that are indicative of advanced HIV disease, regardless of their CD4+ T-cell count.
Some examples of these opportunistic infections and cancers include:
* Pneumocystis pneumonia (PCP)
* Candidiasis (thrush) affecting the esophagus, trachea, or lungs
* Cryptococcal meningitis
* Toxoplasmosis of the brain
* Cytomegalovirus disease
* Kaposi's sarcoma
* Non-Hodgkin's lymphoma
* Invasive cervical cancer
It is important to note that with appropriate antiretroviral therapy (ART), people living with HIV can maintain their CD4+ T-cell counts, suppress viral replication, and prevent the progression to AIDS. Early diagnosis and consistent treatment are crucial for managing HIV and improving life expectancy and quality of life.
'Mycobacterium tuberculosis' is a species of slow-growing, aerobic, gram-positive bacteria that demonstrates acid-fastness. It is the primary causative agent of tuberculosis (TB) in humans. This bacterium has a complex cell wall rich in lipids, including mycolic acids, which provides a hydrophobic barrier and makes it resistant to many conventional antibiotics. The ability of M. tuberculosis to survive within host macrophages and resist the immune response contributes to its pathogenicity and the difficulty in treating TB infections.
M. tuberculosis is typically transmitted through inhalation of infectious droplets containing the bacteria, which primarily targets the lungs but can spread to other parts of the body (extrapulmonary TB). The infection may result in a spectrum of clinical manifestations, ranging from latent TB infection (LTBI) to active disease. LTBI represents a dormant state where individuals are infected with M. tuberculosis but do not show symptoms and cannot transmit the bacteria. However, they remain at risk of developing active TB throughout their lifetime, especially if their immune system becomes compromised.
Effective prevention and control strategies for TB rely on early detection, treatment, and public health interventions to limit transmission. The current first-line treatments for drug-susceptible TB include a combination of isoniazid, rifampin, ethambutol, and pyrazinamide for at least six months. Multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of M. tuberculosis present significant challenges in TB control and require more complex treatment regimens.
CD4-positive T-lymphocytes, also known as CD4+ T cells or helper T cells, are a type of white blood cell that plays a crucial role in the immune response. They express the CD4 receptor on their surface and help coordinate the immune system's response to infectious agents such as viruses and bacteria.
CD4+ T cells recognize and bind to specific antigens presented by antigen-presenting cells, such as dendritic cells or macrophages. Once activated, they can differentiate into various subsets of effector cells, including Th1, Th2, Th17, and Treg cells, each with distinct functions in the immune response.
CD4+ T cells are particularly important in the immune response to HIV (human immunodeficiency virus), which targets and destroys these cells, leading to a weakened immune system and increased susceptibility to opportunistic infections. The number of CD4+ T cells is often used as a marker of disease progression in HIV infection, with lower counts indicating more advanced disease.
Inflammation is a complex biological response of tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. It is characterized by the following signs: rubor (redness), tumor (swelling), calor (heat), dolor (pain), and functio laesa (loss of function). The process involves the activation of the immune system, recruitment of white blood cells, and release of inflammatory mediators, which contribute to the elimination of the injurious stimuli and initiation of the healing process. However, uncontrolled or chronic inflammation can also lead to tissue damage and diseases.
Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.
A cohort study is a type of observational study in which a group of individuals who share a common characteristic or exposure are followed up over time to determine the incidence of a specific outcome or outcomes. The cohort, or group, is defined based on the exposure status (e.g., exposed vs. unexposed) and then monitored prospectively to assess for the development of new health events or conditions.
Cohort studies can be either prospective or retrospective in design. In a prospective cohort study, participants are enrolled and followed forward in time from the beginning of the study. In contrast, in a retrospective cohort study, researchers identify a cohort that has already been assembled through medical records, insurance claims, or other sources and then look back in time to assess exposure status and health outcomes.
Cohort studies are useful for establishing causality between an exposure and an outcome because they allow researchers to observe the temporal relationship between the two. They can also provide information on the incidence of a disease or condition in different populations, which can be used to inform public health policy and interventions. However, cohort studies can be expensive and time-consuming to conduct, and they may be subject to bias if participants are not representative of the population or if there is loss to follow-up.
Immune reconstitution inflammatory syndrome
Justin Stebbing
Liise-anne Pirofski
Irini Sereti
Emmonsiosis
Andrew Kambugu
Jarisch-Herxheimer reaction
Opportunistic infection
Fever of unknown origin
Tuberculosis in relation to HIV
Thumbi Ndung'u
Histoplasma duboisii
Progressive multifocal leukoencephalopathy
Diffuse infiltrative lymphocytosis syndrome
List of syndromes
Iris
List of skin conditions
Janus kinase 3
TTC7A
Sarcoidosis
Lipopolysaccharide binding protein
Postpartum physiological changes
MAP3K1
Artificial cell
Immune tolerance
T cell
FOXP3
RELA
Endogenous retrovirus
Organoid
Immune reconstitution inflammatory syndrome - Wikipedia
Immune reconstitution inflammatory syndrome: incidence and implications for mortality
Aberrant Inflammasome Activation Characterizes Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome
Leprosy as Immune Reconstitution Inflammatory Syndrome in HIV-positive Persons - Volume 13, Number 9-September 2007 - Emerging...
HIV Primary Care and Prevention COE: This Month in HIV: Immune Reconstitution Inflammatory Syndrome (IRIS): 'Why Is My Patient...
Acute cytomegalovirus colitis presenting during primary HIV infection: an unusual case of an immune reconstitution inflammatory...
Kaposi Sarcoma Immune Reconstitution Inflammatory Syndrome: Biomarkers and Factors Associated with Survival | Fred Hutchinson...
HIV-associated Neurocognitive Disorder (HAND): Overview, Pathophysiology, Epidemiology
DailyMed - TROGARZO- ibalizumab injection, solution
Severe leukoencephalopathy with fulminant cerebral edema reflecting immune reconstitution inflammatory syndrome during HIV...
Immune reconstitution inflammatory syndrome associated with Kaposi sarcoma: higher incidence and mortality in Africa than in...
Unmasking immune reconstitution inflammatory syndrome (IRIS): A report of five cases and review of the literature
Immune Reconstitution Inflammatory Syndrome and the Influence of T Regulatory Cells: A Cohort Study in the Gambia - The Jenner...
Tuberculosis-associated immune reconstitution inflammatory syndrome: a manifestation of adaptive or innate immunity? [comment]<...
Cause-Specific Mortality and the Contribution of Immune Reconstitution Inflammatory Syndrome in the First 3 Years after...
Herpes zoster infection as an immune reconstitution inflammatory syndrome in HIV-seropositive subjects: a review - Fingerprint ...
Matrix degradation in human immunodeficiency virus type 1-associated tuberculosis and tuberculosis immune reconstitution...
SSA - POMS: DI 34001.036 - Immune System Disorders - 10/06/2023
Apo-Abacavir - Uses, Side Effects, Interactions - MedBroadcast.com
ibalizumab-uiyk (Trogarzo) - International Association of Providers of AIDS Care
Sporotrichosis: Background, Pathophysiology, Epidemiology
View All Pages | Cancer.Net
Progressive Multifocal Leukoencephalopathy in HIV: Overview, Pathophysiology, Epidemiology
Reyes Corcho Andres
Frontiers | Lysosomal Cathepsin Release Is Required for NLRP3-Inflammasome Activation by Mycobacterium tuberculosis in Infected...
Irini Sereti - Wikipedia
Treatment Recommendations for HIV-Infected Patients With Co-infections: Overview, Treatment of Hepatitis B Virus With...
Francis Gigliotti, M.D. | UR Medicine
Home - Professor Robert Wilkinson
IRIS24
- Immune reconstitution inflammatory syndrome (IRIS) is a condition seen in some cases of HIV/AIDS or immunosuppression, in which the immune system begins to recover, but then responds to a previously acquired opportunistic infection with an overwhelming inflammatory response that paradoxically makes the symptoms of infection worse. (wikipedia.org)
- IRIS may also be referred to as immune reconstitution syndrome, immune reconstitution disease, immune recovery disease, and immune restoration disease. (wikipedia.org)
- IRIS in these patients is thought to be due to the pro-inflammatory response after withdrawal of immunosuppressants. (wikipedia.org)
- To describe incidence of immune reconstitution inflammatory syndrome (IRIS) and its association with mortality in a large multisite US HIV-infected cohort applying an objective, comprehensive definition. (nih.gov)
- Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) complicates combination antiretroviral therapy (cART) in up to 25% of patients with HIV/TB coinfection. (diva-portal.org)
- We propose that inflammasome activation in monocytes/macrophages of HIV/TB patients increases with ineffective T cell-dependent activation of monocytes/macrophages, priming them for an excessive inflammatory response after cART is commenced, which is greatest in patients with TB-IRIS. (diva-portal.org)
- Recently, the phenomenon of immune reconstitution inflammatory syndrome (IRIS), or leprosy reversal response, has received attention. (cdc.gov)
- discovered that patients known to have HIV and leprosy, when treated with HAART manifested a type 1 reversal reaction, acute leprosy inflammatory episode ( 4 ), or IRIS. (cdc.gov)
- HIV Primary Care and Prevention COE: This Month in HIV: Immune Reconstitution Inflammatory Syndrome (IRIS): 'Why Is My Patient Getting Worse? (hivguidelines.org)
- Immune Reconstitution Inflammatory Syndrome (IRIS) has been reported in patients treated with combination antiretroviral therapies. (nih.gov)
- To assess the incidence, predictors, and outcomes of Kaposi sarcoma-associated paradoxical immune reconstitution inflammatory syndrome (KS-IRIS) in antiretroviral therapy (ART)-naive HIV-infected patients with Kaposi sarcoma initiating ART in both well resourced and limited-resourced settings. (qxmd.com)
- Immune reconstitution inflammatory syndromes (IRIS) in patients with acquired immune deficiency syndrome (AIDS) are characterised by atypical manifestations of opportunistic pathogens. (elsevierpure.com)
- Although well established as a syndrome, IRIS still presents challenges in diagnosis and management. (elsevierpure.com)
- Balkhair, A , Ahamed, S & Sankhla, D 2011, ' Unmasking immune reconstitution inflammatory syndrome (IRIS): A report of five cases and review of the literature ', Sultan Qaboos University Medical Journal , المجلد 11, رقم 1, الصفحات 95-103. (elsevierpure.com)
- Methods: We performed a cross-sectional study of matrix turnover in HIV type 1 (HIV-1)-infected and -uninfected TB patients and controls, and a prospective cohort study of HIV-1-infected TB patients at risk of TB immune reconstitution inflammatory syndrome (TB-IRIS), in Cape Town, South Africa. (figshare.com)
- We determined cause-specific mortality and the contribution of immune reconstitution inflammatory syndrome (IRIS) in a well-characterized patient cohort in Kampala, Uganda, over a 36-month period of ART. (mak.ac.ug)
- We present an Acute Respiratory Distress Syndrome (ARDS) case after a caesarean section related to the Immune Reconstitution Inflammatory Syndrome (IRIS) in a Guinean black woman. (scirp.org)
- Results Several studies refer to the immune reconstitution inflammatory syndrome (IRIS) as a plausible explanation of reactivation of MS after withdrawal of natalizumab: a rebound effect or secondary action of the organism in response to the primary immunosuppression caused by the drug. (thieme-connect.de)
- This quote is from a medical article about IRIS (immune reconstitution inflammatory syndrome. (drlwilson.com)
- In allopathic medicine, they are called IRIS (immune reconstitution inflammatory syndrome) and Jarisch-Herxheimer reactions - named after two doctors who first noticed them. (drlwilson.com)
- In acquired immunodeficiency syndrome (AIDS) patients, immune reconstitution inflammatory syndrome (IRIS) due to Mycobacterium avium complex (MAC) infection is one of the most difficult IRIS types to manage. (koreamed.org)
- Secondly, immune reconstitution inflammatory syndrome (IRIS) can occur in some patients after starting HAART, resulting in an exacerbation of KS lesions due to the immune system's reactivation. (alliedacademies.org)
- ART, OIs can present when the immune system starts to recover aka immune reconstitution inflammatory syndrome (IRIS). (cdc.gov)
- Natural killer cell degranulation capacity predicts early onset of the immune reconstitution inflammatory syndrome (IRIS) in HIV-infected patients with tuberculosis. (bvsalud.org)
Infection16
- In some severe cases, anti-inflammatory medications, such as corticosteroids are needed to suppress inflammation until the infection has been eliminated. (wikipedia.org)
- Severe immunosuppression caused by primary HIV infection resulted in cytomegalovirus colitis, and initiation of early combination antiretroviral therapy triggered an immune reconstitution inflammatory syndrome potentially leading to colonic perforation. (uzh.ch)
- [ 1 ] In addition to its effects on the cellular immune system, HIV enters the central nervous system (CNS) early in the course of the infection and causes several important CNS conditions over the course of the disease, such as HIV encephalopathy and HAND. (medscape.com)
- Immune reconstitution inflammatory syndrome may also occur as severe leukoencephalopathy with fulminant cerebral edema during HIV infection with rapid immune reconstitution. (biomedcentral.com)
- 3. Immune deficiency disorders, excluding HIV infection (14.00E) . Immune deficiency disorders are characterized by recurrent or unusual infections that respond poorly to treatment, and are often associated with complications affecting other parts of the body. (ssa.gov)
- HIV infection destroys CD4 (T) cells, which are important to the immune system. (medbroadcast.com)
- Acquired immune deficiency syndrome (AIDS) is a disease of the immune system caused by infection with the human immunodeficiency virus (HIV). (cancer.net)
- When HIV infection causes symptoms and specific disease syndromes, the disease is called AIDS. (cancer.net)
- The pro-inflammatory cytokine IL-1β is thought to play a major role in host protection against Mycobacterium tuberculosis (Mtb) infection ( 1 - 8 ). (frontiersin.org)
- Sereti researches the pathogenesis of HIV infection emphasizing mechanisms of immune reconstitution inflammatory syndrome in advanced HIV infection and of serious non-AIDS events in treated HIV-infected patients. (wikipedia.org)
- She also investigates the pathogenesis of idiopathic CD4 lymphocytopenia (ICL) and immune-based therapeutic strategies of HIV infection and ICL. (wikipedia.org)
- The second major area of emphasis is the study of lung injury resulting from immune-mediated inflammation in response to infection with P. carinii. (rochester.edu)
- however, the immune response to HBV vaccine is lower in patients with HIV infection than in uninfected patients, and postvaccination HBsAg must be tested to document immunity. (medscape.com)
- Clinical outcome after infection range from asymptomatic infection to life threatening dengue shock syndrome. (pasteur-kh.org)
- The primary therapeutic goal is to control the HIV infection through adherence to HAART, as this significantly improves immune function and helps control KS progression. (alliedacademies.org)
- Delayed and incomplete reconstitution of the ADAPTIVE IMMUNE system in particular involving T-CELLS is associated with increase or relapse of infection. (bvsalud.org)
Infections6
- Generally, immune reconstitution inflammatory syndrome is based on opportunistic infections, but rare cases of immune reconstitution inflammatory syndrome inducing demyelinization of the nervous system have also been observed. (biomedcentral.com)
- Immune system disorders may result in recurrent and unusual infections, or inflammation and dysfunction of the body's own tissues. (ssa.gov)
- The immune system helps fight infections. (medbroadcast.com)
- This may reduce your risk of death or getting opportunistic infections (OIs) that can happen when your immune system is weak. (iapac.org)
- Our mission is to provide insight into both the innate and adaptive immune response to various viral infections for novel vaccine and therapeutics design. (pasteur-kh.org)
- Regeneration of normal immune function after immune depleting procedures or infections (e.g. (bvsalud.org)
Antiretroviral therapy4
- Immune reconstitution inflammatory syndrome is a well-known complication in HIV-infected patients after initiation of highly active antiretroviral therapy resulting in rapid CD4 + cell count recovery and suppression of viral load. (biomedcentral.com)
- The benefit of highly active antiretroviral therapy (HAART) in HIV-infected patients is the restoration of the immune system. (biomedcentral.com)
- HIV-associated PML also occurs during immune recovery following the initiation of highly active antiretroviral therapy (HAART). (medscape.com)
- In cases associated with the initiation of highly active antiretroviral therapy (HAART), immune recovery may uncover pre-existing subclinical PML. (medscape.com)
HAART1
- The introduction of HAART revolutionized the treatment of HIV/AIDS, leading to improved immune function, decreased viral replication, and increased CD4 cell counts. (alliedacademies.org)
AIDS5
- It was usually observed in the late stages of acquired immunodeficiency syndrome (AIDS), when CD4 + lymphocyte counts fall below 200 cells/mL, and was seen in up to 50% of patients prior to their deaths. (medscape.com)
- HIV is the virus responsible for acquired immune deficiency syndrome (AIDS). (medbroadcast.com)
- The connection between HIV/AIDS and certain cancers is not completely understood, but the link likely depends on a weakened immune system. (cancer.net)
- The outcome of inflammatory PML is more variable than that of PML in end-stage AIDS. (medscape.com)
- Tell your doctor if you have or have ever had PML, an organ transplant, or another condition that affects your immune system such as human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), leukemia (cancer that causes too many blood cells to be produced and released into the bloodstream), or lymphoma (cancer that develops in the cells of the immune system). (medlineplus.gov)
Tuberculosis3
- Tuberculosis-associated immune reconstitution inflammatory syndrome: a manifestation of adaptive or innate immunity? (itg.be)
- What is the cause and best management of the HIV-Tuberculosis-associated Immune Reconstitution Inflammatory Syndrome? (imperial.ac.uk)
- Protective immunity to Mycobacterium tuberculosis (Mtb) -the causative agent of tuberculosis (TB)-is not fully understood but involves immune responses within the pulmonary airways which can lead to exacerbated inflammation and immune pathology. (frontiersin.org)
Mortality4
- Immune reconstitution inflammatory syndrome associated with Kaposi sarcoma: higher incidence and mortality in Africa than in the UK. (qxmd.com)
- The contribution of immune reconstitution inflammatory syndrome to mortality was limited. (mak.ac.ug)
- Together with Dr. Terry Wright, we are trying to develop means to manipulate this inflammatory process so as to decrease the morbidity and mortality associated with P. carinii pneumonia. (rochester.edu)
- Such inflammatory tissue damage is responsible for morbidity and mortality in patients. (ersjournals.com)
Natalizumab2
- PML has also been reported in patients receiving immune therapy with monoclonal antibodies (eg, natalizumab, rituximab) and various other immunosuppressants, including prednisone, cyclophosphamide, methotrexate, and cyclosporine. (medscape.com)
- Method Extending this source of evidence, this work reviews research that demonstrates secondary worsening of MS after discontinuation of natalizumab, a human monoclonal antibody that suppresses the disease inflammatory activity as primary action. (thieme-connect.de)
Responses5
- Systemic or local inflammatory responses may occur with improvement in immune function. (wikipedia.org)
- 2. Autoimmune disorders (14.00D) . Autoimmune disorders are caused by dysfunctional immune responses directed against the body's own tissues, resulting in chronic, multisystem impairments that differ in clinical manifestations, course, and outcome. (ssa.gov)
- Prospective assessment of humoral and cellular immune responses to a 3rd COVID-19 mRNA vaccine dose among immunocompromised individuals. (amedeo.com)
- It is characterized by anti-inflammatory cellular responses that allow embryonic implantation. (scirp.org)
- Genetic HPS is heterogeneous and arises from defects in the critical regulatory pathways responsible for the natural termination of immune responses that lead to the failure of the homeostatic removal of cells that are superfluous or dangerous to the host. (biomedcentral.com)
High pill burden1
- Reconstitution immune syndrome, 1 pharmacologic interactions, and high pill burden argue against a simultaneous beginning of HIV and TB treatments. (lww.com)
Lymphoma1
- Naghashpour M, Setoodeh R, Moscinski L, Bergier G, McCardle T, Glass F, Sokol L. Nonnecrobiotic necrobiotic xanthogranuloma as an initial manifestation of paraproteinemia and small lymphocytic lymphoma in a patient with Sjögren syndrome. (moffitt.org)
Patients5
- Postpartum patients During pregnancy, the immune system is relatively suppressed to prevent fetal rejections or miscarriages. (wikipedia.org)
- [ 2 ] As part of the acute HIV syndrome during seroconversion, patients may experience HIV encephalopathy. (medscape.com)
- Resolutive Results with Oral Corticosteroids for Patients with COVID-19 in Pulmonary Inflammatory Phase. (scirp.org)
- Use caution when switching patients from long-acting therapies with immune effects. (medscape.com)
- treatment can restore immune function in most patients if suppression of replication is sustained. (msdmanuals.com)
Inflammation1
- Plasmatic HIV-1 soluble gp120 is associated with correlates of immune dysfunction and inflammation in ART-treated individuals with undetectable viremia. (amedeo.com)
Cells3
- These medications target CD4 immune cells, suppressing their function. (wikipedia.org)
- Reducing the amount of HIV and increasing the CD4 cells in your blood may help improve your immune system. (iapac.org)
- Hemophagocytic syndrome (HPS) is a potentially fatal condition due to dysregulated lymphocyte activation and proliferation, mainly characterised by impaired or inactive natural killer (NK) cells and cytotoxic T cells, which leads to macrophage hyperactivation and over-expression of cytokines [ 1 ]. (biomedcentral.com)
Suppression2
- When reactivation happens in the setting of immune suppression, viral replication ensues, causing dissemination to the brain. (medscape.com)
- Starting ART early, followed by continuous lifetime treatment, most effectively achieves durable virologic suppression and restoration of immune function that can improve clinical outcomes and prevent transmission to partners who are seronegative. (aafp.org)
Acute1
- This massive inflammatory process led to acute colon perforation. (uzh.ch)
Immunology1
- The Immunology Unit researches the human host immune response to infectious diseases of high prevalence in Cambodia. (pasteur-kh.org)
Reaction2
- While this inflammatory reaction is usually self-limited, there is risk of long-term symptoms and death, particularly when the central nervous system is involved. (wikipedia.org)
- [ 8 ] Such cases are associated with an inflammatory reaction in brain lesions and contrast enhancement on neuroimaging studies. (medscape.com)
Lesions1
- Magnetic resonance imaging of the brain showed extensive white matter lesions, and analysis of cerebrospinal fluid revealed an immunoreactive syndrome. (biomedcentral.com)
Generally1
- Generally, we need your medical history, a report(s) of a physical examination, a report(s) of laboratory findings, and in some instances, appropriate medically acceptable imaging or tissue biopsy reports to show that you have an immune system disorder. (ssa.gov)
Disease3
- Immune reconstitution inflammatory syndrome in this form seems to represent a severe autoimmunologic disease of the brain with specific histopathologic findings. (biomedcentral.com)
- It highlights the significance of neutrophil function on TB disease outcome and underlines the necessity of monitoring neutrophil function for better assessment of the immune response and severity of lung pathology associated with TB. (frontiersin.org)
- Even secondary HPS occurs as an imbalance between insufficient host defense, obstinate hyperinflammation, and a heterogeneous triggering event, which can be of infectious, rheumatic or neoplastic nature: therefore, the clinical disease results as the signature of a dysregulated immune activation, leading to macrophage proliferation and widespread hemophagocytosis in the reticuloendothelial system. (biomedcentral.com)
Response5
- If the CD4 count rapidly increases (due to effective treatment of HIV, or removal of other causes of immunosuppression), a sudden increase in the inflammatory response produces nonspecific symptoms such as fever, and in some cases a worsening of damage to the infected tissue. (wikipedia.org)
- The initial immune response leads to the formation of a Ghon focus. (ersjournals.com)
- After inhalation, infective droplets deposit at the lung bases, where the initial immune response forms the Ghon focus (arrow). (ersjournals.com)
- Once implanted at the apex, Mtb must engage the host immune response to drive matrix destruction, resulting in cavities within which it proliferates exponentially. (ersjournals.com)
- Within the lung, Mtb is initially contained by granuloma formation, the characteristic host immune response to the pathogen [ 7 ]. (ersjournals.com)
Diseases1
- Hemophagocytic syndrome (HPS) is clinically defined as a combination of fever, liver dysfunction, coagulation abnormalities, pancytopenia, progressive macrophage proliferation throughout the reticuloendothelial system, and cytokine over-production, and may be primary or secondary to infectious, auto-immune, and tumoral diseases. (biomedcentral.com)
System13
- In either scenario, there is hypothesized reconstitution of antigen-specific T cell-mediated immunity with activation of the immune system against persisting antigen, whether present as intact organisms, dead organisms, or debris. (wikipedia.org)
- A. What disorders do we evaluate under the immune system disorders listings? (ssa.gov)
- 1. We evaluate immune system disorders that cause dysfunction in one or more components of your immune system. (ssa.gov)
- Immune system disorders can cause a deficit in a single organ or body system that results in extreme (that is, very serious) loss of function. (ssa.gov)
- B. What information do we need to show that you have an immune system disorder? (ssa.gov)
- The precise meaning will depend on the specific immune system disorder, the usual course of the disorder, and the other circumstances of your clinical course. (ssa.gov)
- It is used in combination with other anti-HIV medications to slow further growth or reproduction of HIV and it seems to slow down the destruction of the immune system. (medbroadcast.com)
- A person with HIV is highly vulnerable to life-threatening conditions because HIV severely weakens the body's immune system. (cancer.net)
- You have ever been treated with certain medications that weaken the immune system. (medlineplus.gov)
- Also tell your doctor if you are taking or if you have ever taken any other medications that affect the immune system. (medlineplus.gov)
- Risk of additive immune system effects with etrasimod has not been studied in combination with antineoplastic, immune-modulating, or noncorticosteroid immunosuppressive therapies. (medscape.com)
- A better understanding of the pathophysiology of HPS may clarify the interactions between the immune system and the variously implicated potential infectious agents. (biomedcentral.com)
- The result of this process is uncontrolled and ineffective immune activation, multi-organ dysfunction, and hemophagocytosis throughout the reticuloendothelial system [ 2 ]. (biomedcentral.com)
Macrophage2
- Neither classical nor alternative macrophage activation is required for Pneumocystis clearance during immune reconstitution inflammatory syndrome. (rochester.edu)
- The syndrome was first described in 1939 as poorly-controlled histiocyte proliferation, but has since also been called hemophagocytic histiocytosis and macrophage activation syndrome [ 5 - 7 ]. (biomedcentral.com)
Symptoms1
- a virus that many people are exposed to during childhood that usually causes no symptoms but may cause PML in people with weakened immune systems). (medlineplus.gov)
Processes1
- the extent of which depends on specific host pro-inflammatory processes. (frontiersin.org)
Lung1
- Neutrophils, though increasingly linked to the development of inflammatory disorders, have been less well studied in relation to TB-induced lung pathology. (frontiersin.org)
Checkpoint1
- Nivolumab is an immune checkpoint inhibitor approved for the treatment of metastatic cancers. (koreamed.org)
Disorders2
Severe2
- Twelve hours after admission, the patient developed severe psycho-organic syndrome and repeated generalized epileptic seizures. (biomedcentral.com)
- MCMs developed for smallpox preparedness or shown to be effective against other OPXVs (i.e., tecovirimat, brincidofovir, cidofovir, trifluridine ophthalmic solution, and vaccinia immune globulin intravenous [VIGIV]) have been used to treat severe mpox. (cdc.gov)
Function1
- Such parameters can be realistically linked to neutrophil function and/or interaction with other immune cell populations in the view of their specific activities described in subsequent sections below. (frontiersin.org)
Researches1
- Sereti researches immune reconstitution inflammatory syndrome, idiopathic CD4 lymphocytopenia, and immune-based therapeutic strategies of HIV investigation. (wikipedia.org)
Decrease1
- By what immune mechanism does vitamin D decrease susceptibility to TB? (imperial.ac.uk)
Therapies1
- Finally, we propose that some MMPs, ROS, MPO, S100A8/A9 and Glutathione are neutrophil-related inflammatory mediators with promising potential as targets for developing host-directed therapies for TB. (frontiersin.org)
Recovery1
- Recurrence of PML despite many years of immune recovery in HIV has been reported. (medscape.com)