Ja. Desimone et al., Inflammatory reactions in HIV-1-infected persons after initiation of highly active antiretroviral therapy, ANN INT MED, 133(6), 2000, pp. 447-454
Citations number
94
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Purpose: To review reported inflammatory reactions occurring after initiati
on of highly active antiretroviral therapy (HAART) in persons infected with
HIV-1 and to explore the mechanisms leading to these reactions.
Data Sources: MEDLINE search of biomedical literature reporting inflammator
y reactions after HAART. Bibliographies of retrieved reports were also revi
ewed.
Study Selection: Articles describing patients infected with HIV-1 who had i
mmunologic and virologic responses to HAART and subsequently developed infl
ammatory reactions.
Data Extraction: Data on the immune status, clinical characteristics, and t
herapeutic management of patients who were seropositive for HIV-1 and had i
nflammatory reactions after HAART.
Data Synthesis: Inflammatory reactions involving opportunistic infections,
AIDS-associated malignant conditions, and other non-infectious diseases hav
e recently been described in patients infected with HIV-1. These conditions
often appeared shortly after the introduction of HAART and were associated
with pronounced reductions in plasma HIV-1 viral load and increases in CD4
(+) T-lymphocyte counts. Clinical presentation was often atypical of that i
n patients with untreated HIV-1 infection, probably because of restored imm
unity. Most cases improved despite continuation of HAART, although some pat
ients required anti-inflammatory drugs or specific antimicrobial agents.
Conclusions: Clinicians caring for patients who are infected with HIV-1 and
receiving HAART must be aware of this new and diverse clinical syndrome. A
s more HAART recipients are studied. new presentations will probably be obs
erved.