Severe mycobacterial IRIS in advanced HIV has features of hemophagocytic lymphohistiocytosis and requires prolonged immune suppression.

Joseph M RoccoElizabeth LaidlawFrances GalindoMegan AndersonAdam RupertJeanette HigginsOrnella SortinoAna M Ortega-VillaVirginia SheikhGregg RobySafia KuriakoseAndrea LiscoMaura ManionIrini Sereti

Published in: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2022)

Severe mycobacterial-IRIS and HLH have an overlapping pathogenesis involving IFNγ and unopposed T-cell activation causing severe inflammatory disease clinically distinguished by hyperferritinemia (hyperferritinemic IRIS or FIRIS). Hemoglobin, ferritin, CXCL-9, and sCD25 identify this high-risk population and may improve risk stratification and therapeutic strategies for mycobacterial-IRIS.

Keyphrases

mycobacterium tuberculosis
early onset
hiv infected
antiretroviral therapy
immune response
hiv positive
human immunodeficiency virus
drug induced
hiv aids