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Review
. 2021 Jan 27;11(2):95.
doi: 10.3390/life11020095.

Cryptococcal Immune Reconstitution Inflammatory Syndrome: From Blood and Cerebrospinal Fluid Biomarkers to Treatment Approaches

Vânia Maria Sabadoto Brienze  1 , Júlio César André  2 , Elisabete Liso  1 , Irina Vlasova-St Louis  3
Affiliations
Review

Cryptococcal Immune Reconstitution Inflammatory Syndrome: From Blood and Cerebrospinal Fluid Biomarkers to Treatment Approaches

Vânia Maria Sabadoto Brienze et al. Life (Basel). .

Abstract

Immune reconstitution inflammatory syndrome (IRIS) presents as an exaggerated immune reaction that occurs during dysregulated immune restoration in immunocompromised patients in late-stage human immunodeficiency virus (HIV) infection who have commenced antiretroviral treatments (ART). Virtually any opportunistic pathogen can provoke this type of immune restoration disorder. In this review, we focus on recent developments in the identification of risk factors for Cryptococcal IRIS and on advancements in our understanding of C-IRIS immunopathogenesis. We overview new findings in blood and cerebrospinal fluid which can potentially be useful in the prediction and diagnosis of cryptococcal meningitis IRIS (CM-IRIS). We assess current therapeutic regimens and novel treatment approaches to combat CM-IRIS. We discuss the utility of biomarkers for clinical monitoring and adjusting treatment modalities in acquired immunodeficiency syndrome (AIDS) patients co-infected with Cryptococcus who have initiated ART.

Keywords: AIDS/HIV; antiretroviral therapy (ART); blood biomarkers; cerebrospinal fluid biomarkers; cryptococcal meningitis (CM); immune reconstitution inflammatory syndrome (IRIS).

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Conflict of interest statement

No potential conflict of interest.

References

    1. World Health Organization Cryptococcal Disease: What’s New and Important. [(accessed on 12 July 2020)]; Available online: https://www.who.int/hiv/mediacentre/news/cryptococcal-disease-key-messag...
    1. Williamson P.R., Jarvis J.N., Panackal A.A., Fisher M.C., Molloy S.F., Loyse A., Harrison T.S. Cryptococcal meningitis: Epidemiology, immunology, diagnosis and therapy. Nat. Rev. Neurol. 2016;13:13–24. doi: 10.1038/nrneurol.2016.167. - DOI - PubMed
    1. Liu P., Dillingham R., McManus K.A. Hospital days attributable to immune reconstitution inflammatory syndrome in persons living with HIV before and after the 2012 DHHS HIV guidelines. AIDS Res. Ther. 2017;14:25. doi: 10.1186/s12981-017-0152-0. - DOI - PMC - PubMed
    1. Tenforde M.W., Gertz A.M., Lawrence D.S., Wills N.K., Guthrie B.L., Farquhar C., Jarvis J.N. Mortality from HIV-associated meningitis in sub-Saharan Africa: A systematic review and meta-analysis. J. Int. AIDS Soc. 2020;23 doi: 10.1002/jia2.25416. - DOI - PMC - PubMed
    1. Hoyo-Ulloa I., Belaunzarán-Zamudio P.F., Crabtree-Ramirez B., Galindo-Fraga A., Pérez-Aguinaga M.E., Sierra-Madero J.G. Impact of the immune reconstitution inflammatory syndrome (IRIS) on mortality and morbidity in HIV-infected patients in Mexico. Int. J. Infect. Dis. 2011 doi: 10.1016/j.ijid.2011.02.007. - DOI - PMC - PubMed

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