Publication: Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions
Issued Date
2010-11-01
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ISSN
14733099
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2-s2.0-78049441467
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Mahidol University
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SCOPUS
Bibliographic Citation
The Lancet Infectious Diseases. Vol.10, No.11 (2010), 791-802
Suggested Citation
Lewis J. Haddow, Robert Colebunders, Graeme Meintjes, Stephen D. Lawn, Julian H. Elliott, Yukari C. Manabe, Paul R. Bohjanen, Somnuek Sungkanuparph, Philippa J. Easterbrook, Martyn A. French, David R. Boulware Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions. The Lancet Infectious Diseases. Vol.10, No.11 (2010), 791-802. doi:10.1016/S1473-3099(10)70170-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/29498
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Title
Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions
Other Contributor(s)
King's College London
The Nelson R. Mandela Medical School
Prins Leopold Instituut voor Tropische Geneeskunde
Universiteit Antwerpen
University of Cape Town
London School of Hygiene & Tropical Medicine
University of Cape Town, Faculty of Health Sciences
Alfred Hospital
Macfarlane Burnet Institute for Medical Research
Makerere University
The Johns Hopkins School of Medicine
University of Minnesota Twin Cities
Mahidol University
University of Western Australia
Royal Perth Hospital
The Nelson R. Mandela Medical School
Prins Leopold Instituut voor Tropische Geneeskunde
Universiteit Antwerpen
University of Cape Town
London School of Hygiene & Tropical Medicine
University of Cape Town, Faculty of Health Sciences
Alfred Hospital
Macfarlane Burnet Institute for Medical Research
Makerere University
The Johns Hopkins School of Medicine
University of Minnesota Twin Cities
Mahidol University
University of Western Australia
Royal Perth Hospital
Abstract
Cryptococcal immune reconstitution inflammatory syndrome (IRIS) may present as a clinical worsening or new presentation of cryptococcal disease after initiation of antiretroviral therapy (ART), and is thought to be caused by recovery of cryptococcus-specific immune responses. We have reviewed reports of cryptococcal IRIS and have developed a consensus case definition specifically for paradoxical crytopcoccal IRIS in patients with HIV-1 and known cryptococcal disease before ART, and a separate definition for incident cryptococcosis developed during ART (termed ART-associated cryptococcosis), for which a proportion of cases are likely to be unmasking cryptococcal IRIS. These structured case definitions are intended to aid design of future clinical, epidemiological, and immunopathological studies of cryptococcal IRIS, to standardise diagnostic criteria, and to facilitate comparisons between studies. As for definitions of tuberculosis-associated IRIS, definitions for cryptococcal IRIS should be regarded as preliminary until further insights into the immunopathology of IRIS permit their refinement. © 2010 Elsevier Ltd.