Immune Reconstitution Inflammatory Syndrome in People Living with HIV Who Presented with Interstitial Pneumonitis: an Emerging Challenge in the Era of Rapid Initiation of Antiretroviral Therapy-Reference-Cited by-同舟云学术

Immune Reconstitution Inflammatory Syndrome in People Living with HIV Who Presented with Interstitial Pneumonitis: an Emerging Challenge in the Era of Rapid Initiation of Antiretroviral Therapy

Published:2023-04-13 Issue:2 Volume:11 Page:
ISSN:2165-0497
Container-title:Microbiology Spectrum
language:en
Short-container-title:Microbiol Spectr

Author:

Chen Kai-Hsiang¹,Liu Wang-Da¹²^ORCID,Sun Hsin-Yun¹,Lin Kuan-Yin¹³,Hsieh Szu-Min¹,Sheng Wang-Huei¹⁴⁵,Chuang Yu-Chung¹^ORCID,Huang Yu-Shan¹,Cheng Aristine¹^ORCID,Hung Chien-Ching¹⁶⁷^ORCID

Affiliation:

1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

2. Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan

3. Center of Infection Control, National Taiwan University Hospital, Taipei, Taiwan

4. Department of Medical Education, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

5. School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

6. Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan

7. Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan

Abstract

Our study of PLWH who presented with IP mainly due to Pneumocystis jirovecii demonstrates that a high rate of paradoxical IRIS and a rapid decline of PVL with the initiation of ART, a CD4-to-CD8 ratio of <0.1 at baseline, and a short interval (<7 days) between the diagnosis of IP and the initiation of ART were associated with paradoxical IP-IRIS in PLWH. Paradoxical IP-IRIS was not associated with mortality or respiratory failure with heightened awareness among the HIV-treating physicians, rigorous investigations to exclude the possibilities of concomitant infections, or the malignancies and adverse effects of medications, including the cautious use of corticosteroids.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Cell Biology,Microbiology (medical),Genetics,General Immunology and Microbiology,Ecology,Physiology

Link

https://journals.asm.org/doi/pdf/10.1128/spectrum.04985-22

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