ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Prospective International Study of Incidence and Predictors of Immune Reconstitution Inflammatory Syndrome and Death in People Living With Human Immunodeficiency Virus and Severe Lymphopenia.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Immune reconstitution inflammatory syndrome, a controversial burden in the East African context: a systematic review and meta-analysis.Frontiers in medicine · 2023Pooled it
- Talaromycosis-associated immune reconstitution inflammatory syndrome exhibits immune dysregulation in patients with acquired immunodeficiency syndrome.PLoS neglected tropical diseases · 2026Article
- Temporal shifts in adaptive immunity drive HIV-associated cryptococcal IRIS: mechanisms, models, and therapeutic opportunities.NeuroImmune pharmacology and therapeutics · 2026Article
- [Characterization of immune reconstitution inflammatory syndrome in a Mexican cohort].Revista medica del Instituto Mexicano del Seguro Social · 2026Observational
- Characteristics and outcomes of Kaposi sarcoma herpesvirus-associated inflammatory cytokine syndrome.Blood advances · 2025Article
- Clinical characteristics and prognosis of Talaromycosis marneffei associated immune reconstitution inflammatory syndrome in AIDS patients.PLoS neglected tropical diseases · 2024Article
- Molecular Diagnostics ofDiseases (Basel, Switzerland) · 2024Review
- Clonal hematopoiesis in people with advanced HIV and associated inflammatory syndromes.JCI insight · 2024Article
- Southern African HIV Clinicians Society guideline on the management of non-tuberculous mycobacteria in people with HIV.Southern African journal of HIV medicine · 2024Article
- Cryptococcal meningitis.Nature reviews. Disease primers · 2023Review
- T cell infiltration into the brain triggers pulmonary dysfunction in murine Cryptococcus-associated IRIS.Nature communications · 2023Article
- Immune reconstitution inflammatory syndrome drives emergence of HIV drug resistance from multiple anatomic compartments in a person living with HIV.Nature medicine · 2023Article
- Changes in the balance of Th17/Treg cells and oxidative stress markers in patients with HIV‑associated pulmonary tuberculosis who develop IRIS.Experimental and therapeutic medicine · 2023Article
- C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review.JAC-antimicrobial resistance · 2023Review
- Article
- Article
- Severe Mycobacterial Immune Reconstitution Inflammatory Syndrome (IRIS) in Advanced Human Immunodeficiency Virus (HIV) Has Features of Hemophagocytic Lymphohistiocytosis and Requires Prolonged Immune Suppression.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- A nomogram for predicting paradoxical immune reconstitution inflammatory syndrome associated with cryptococcal meningitis among HIV-infected individuals in China.AIDS research and therapy · 2022Article
- Outcome of Lenalidomide Treatment for Cognitive Impairment Caused by Immune Reconstitution Inflammatory Syndrome in Patients with HIV-Related Cryptococcal Meningitis.Journal of inflammation research · 2022Article
- Immunological Predictors of Post Infectious Inflammatory Response Syndrome in HIV-Negative Immunocompetent Cryptococcal Meningitis.Frontiers in immunology · 2022Article
Corrections and comments
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Authors and funding
23 authors.
Funding
Abstract
backgroundPatients living with human immunodeficiency virus (PLWH) with low CD4 counts are at high risk for immune reconstitution inflammatory syndrome (IRIS) and death at antiretroviral therapy (ART) initiation.
methodsWe investigated the clinical impact of IRIS in PLWH and CD4 counts <100 cells/μL starting ART in an international, prospective study in the United States, Thailand, and Kenya. An independent review committee adjudicated IRIS events. We assessed associations between baseline biomarkers, IRIS, immune recovery at week 48, and death by week 48 with Cox models.
resultsWe enrolled 506 participants (39.3% were women). Median age was 37 years, and CD4 count was 29 cells/μL. Within 6 months of ART, 97 (19.2%) participants developed IRIS and 31 (6.5%) died. Participants with lower hemoglobin at baseline were at higher IRIS risk (hazard ratio [HR], 1.2; P = .004). IRIS was independently associated with increased risk of death after adjustment for known risk factors (HR, 3.2; P = .031). Being female (P = .004) and having a lower body mass index (BMI; P = .003), higher white blood cell count (P = .005), and higher D-dimer levels (P = .044) were also significantly associated with increased risk of death. Decision-tree analysis identified hemoglobin <8.5 g/dL as predictive of IRIS and C-reactive protein (CRP) >106 μg/mL and BMI <15.6 kg/m2 as predictive of death.
conclusionsFor PLWH with severe immunosuppression initiating ART, baseline low BMI and hemoglobin and high CRP and D-dimer levels may be clinically useful predictors of IRIS and death risk.
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