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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient infected with HIV who had normal CD4+ T-cell counts developed Mycobacterium avium complex lymphadenitis associated with restoration of delayed-type hypersensitivity responses to mycobacterial antigens after commencing highly active antiretroviral therapy (Mycobacterium avium immune restoration disease). This case provides further evidence that delayed-type hypersensitivity responses and CD4+ T-cell counts are independent indicators of the cellular immune defects induced by HIV infection and that Mycobacterium avium immune restoration disease may occur in patients with persistently normal CD4+ T-cell counts.
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PMID:Mycobacterium avium infection and immune restoration disease after highly active antiretroviral therapy in a patient with HIV and normal CD4+ counts. 1183 42

The use of highly active antiretroviral therapy (HAART) has led to a substantial decrease in the frequency of opportunistic infections among HIV-infected individuals, along with a significant reduction in their mortality rate. However, a subgroup of HAART-treated patients will exhibit paradoxical deterioration in their clinical status, despite satisfactory control of viral replication and improvements in CD4 lymphocyte counts. This clinical deterioration, known as the immune restoration syndrome or immune reconstitution inflammatory syndrome (IRIS), is a result of an exuberant inflammatory response towards previously diagnosed or incubating opportunistic pathogens, as well as responses towards other as yet undefined antigens. A variety of manifestations of IRIS have been described, most prominently including Mycobacterium avium complex lymphadenitis, paradoxical exacerbations of pulmonary and CNS Mycobacterium tuberculosis infection, paradoxical exacerbations of Cryptococcus neoformans meningitis and cytomegalovirus uveitis. Treatment for this disorder includes continuation of primary therapy against the offending pathogen in order to decrease the antigenic load, continuation of effective HAART, and judicious use of anti-inflammatory agents. Although the clinical manifestations of IRIS are sometimes dramatic, and result in substantial morbidity, the fact that these patients are capable of generating an inflammatory response allows many of them to ultimately discontinue secondary prophylaxis for the offending pathogen.
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PMID:The immune reconstitution inflammatory syndrome. 1287 96

In the last 10 years, interesting results have been reported concerning the impact of highly active antiretroviral therapy (HAART) on the changing pattern of organ-specific manifestations of HIV-1 infection. There has been a clear step-wise reduction in the incidence of several opportunistic infections (OIs), particularly Pneumocystis carinii pneumonia, whereas a nonsignificant reduction in incidence has been observed for other organ-specific diseases, including invasive cervical cancer and Hodgkin disease. In addition, several organ-specific manifestations, including HIV-associated nephropathy, wasting syndrome and cardiomyopathy, are a direct consequence of damage by HIV-1, and so HAART may have a therapeutic effect in improving or preventing these manifestations. Finally, the introduction of HAART has seen the emergence of several complications, termed immune reconstitution inflammatory syndrome, which includes OIs such as cytomegalovirus vitritis, Mycobacterium avium complex lymphadenitis, paradoxical responses to treatment for tuberculosis, and exacerbation of cryptococcosis. Because not all HIV-1 organ-specific manifestations are decreasing in the HAART era, this review will analyse the influence of HAART on several organ-specific manifestations, and in particular OIs related to several organs, cerebral disorders and HIV-1-related neoplasia.
HIV Med 2005 Mar
PMID:Impact of highly active antiretroviral therapy on organ-specific manifestations of HIV-1 infection. 1580 12