We recently summarized our experience with 28 persons with paradoxical immune reconstitution inflammatory syndrome (IRIS) and 81 persons with microbiological relapse. CD4 count and cerebrospinal fluid white blood cell count were higher in IRIS than relapse but neither was reliable enough to routinely differentiate these conditions. Second-episode cryptococcal meningitis remains a difficult clinical scenario as cryptococcal antigen, while excellent for initial diagnosis has no value in differentiating relapse of infection from other causes of recurrent symptoms. Updated research definitions are proposed and rapid, accurate diagnostic tests are urgently needed.
Keyphrases
- cerebrospinal fluid
- free survival
- antiretroviral therapy
- hiv positive
- human immunodeficiency virus
- hiv infected
- single cell
- hepatitis c virus
- peripheral blood
- hiv testing
- oxidative stress
- cell therapy
- hiv aids
- high resolution
- magnetic resonance imaging
- men who have sex with men
- computed tomography
- magnetic resonance
- mass spectrometry
- south africa
- quantum dots
- sensitive detection