Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Nov;10(11):791-802.
doi: 10.1016/S1473-3099(10)70170-5.

Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions

Lewis J Haddow  1 , 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; International Network for the Study of HIV-associated IRIS (INSHI)
Affiliations

Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions

Lewis J Haddow et al. Lancet Infect Dis. 2010 Nov.

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.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

None

References

    1. WHO. Towards Universal Access: Scaling up priority HIV/AIDS interventions in the health sector. Progress report. 2007. Apr [cited 3 Oct. 2008]. Available from: http://www.who.int/hiv/mediacentre/universal_access_progress_report_en.pdf.
    1. Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg KA. Review of human immunodeficiency virus type 1-related opportunistic infections in sub-Saharan Africa. Clin Infect Dis. 2003;36:652–662. - PubMed
    1. Chariyalertsak S, Sirisanthana T, Saengwonloey O, Nelson KE. Clinical presentation and risk behaviours of patients with acquired immunodeficiency syndrome in Thailand, 1994–1998: regional variation and temporal trends. Clin Infect Dis. 2001;32:955–962. - PubMed
    1. Park BJ, Wannemuehler KA, Marston BJ, Govender N, Pappas PG, Chiller TM. Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS. AIDS. 2009;23(4):525–530. - PubMed
    1. Singh N, Perfect JR. Immune reconstitution syndrome associated with opportunistic mycoses. Lancet Infect Dis. 2007 Jun;7(6):395–401. - PubMed

Publication types

MeSH terms

Substances