ReviewAJNR. American journal of neuroradiology2013
CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 1: overview and discussion of progressive multifocal leukoencephalopathy-immune reconstitution inflammatory syndrome and cryptococcal-immune reconstitution inflammatory syndrome.
Review in AJNR. American journal of neuroradiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
26 citing papers in PubMed, 77 citations in OpenAlex.
- Isolated Central Nervous System Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome-Case Report and Literature Review.Respirology case reports · 2026Article
- Individualized immunotherapy for immune reconstitution-associated cortical encephalitis in an HIV-positive cryptococcal meningitis patient: a case report.Frontiers in immunology · 2026Article
- MRI changes in cryptococcal meningoencephalitis exacerbated by antifungal treatment due to post-infectious inflammatory syndrome: A case report.Radiology case reports · 2024Article
- John Cunningham Virus and Progressive Multifocal Leukoencephalopathy: A Falsely Played Diagnosis.Diseases (Basel, Switzerland) · 2024Review
- Brain opportunistic infections and tumors in people living with HIV - still a challenge in efficient antiretroviral therapy era.Journal of neurovirology · 2023Observational
- Article
- MRI imaging features of HIV-related central nervous system diseases: diagnosis by pattern recognition in daily practice.Japanese journal of radiology · 2021Review
- Progressive multifocal leukoencephalopathy and the spectrum of JC virus-related disease.Nature reviews. Neurology · 2021Review
- Review
- Susceptibility-Weighted MR Imaging Hypointense Rim in Progressive Multifocal Leukoencephalopathy: The End Point of Neuroinflammation and a Potential Outcome Predictor.AJNR. American journal of neuroradiology · 2019Article
- Simultaneous Development of Progressive Multifocal Leukoencephalopathy and Cryptococcal Meningitis during Methotrexate and Infliximab Treatment.Internal medicine (Tokyo, Japan) · 2019Article
- Imaging spectrum of immunomodulating, chemotherapeutic and radiation therapy-related intracranial effects.The British journal of radiology · 2018Review
- Neuroimaging in Central Nervous System Infections.Current neurology and neuroscience reports · 2017Review
- Immune Reconstitution Inflammatory Syndrome Unmasking or Worsening AIDS-Related Progressive Multifocal Leukoencephalopathy: A Literature Review.Frontiers in immunology · 2017Review
- Integrated therapy for HIV and cryptococcosis.AIDS research and therapy · 2016Review
- Update and New Directions in Therapeutics for Neurological Complications of HIV Infections.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2016Review
- Punctate and curvilinear gadolinium enhancing lesions in the brain: a practical approach.Neuroradiology · 2016Review
- Neurological immune reconstitution inflammatory response: riding the tide of immune recovery.Current opinion in neurology · 2015Review
- Immune reconstitution inflammatory syndrome in HIV-infected patients.HIV/AIDS (Auckland, N.Z.) · 2015Review
- Opportunistic infections and AIDS malignancies early after initiating combination antiretroviral therapy in high-income countries.AIDS (London, England) · 2014Article
Corrections and comments
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Authors and funding
7 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
summaryWhile uncommon, CNS-IRIS developing after the initiation of HAART in the setting of HIV-related severe immunosuppression is characterized by an intense inflammatory reaction to dead or latent organisms or to self-antigens due to a heightened but dysregulated immune response. While this reaction can range from mild to fulminating, encompassing a very wide clinical spectrum, it is important to recognize because changes in medical management may be necessary to prevent neurologic decline and even death. Once contained, however, this inflammatory response can be associated with improved patient outcome as immune function is restored. Among the infectious organisms that are most commonly associated with CNS-IRIS are the JC virus and Cryptococcus organisms, which will be the subject of this review. CD8 cell infiltration in the leptomeninges, perivascular spaces, blood vessels, and even parenchyma seems to be the pathologic hallmark of CNS-IRIS. While recognition of CNS-IRIS may be difficult, the onset of new or progressive clinical symptoms, despite medical therapy and despite improved laboratory data, and the appearance on neuroimaging studies of contrast enhancement, interstitial edema, mass effect, and restricted diffusion in infections not typically characterized by these findings in the untreated HIV-infected patient should raise the strong suspicion for CNS-IRIS. While CNS-IRIS is a diagnosis of exclusion, the neuroradiologist can play a critical role in alerting the clinician to the possibility of this syndrome.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.