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

Lewis J. Haddow, 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

Research output: Contribution to journalReview articlepeer-review

189 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)791-802
Number of pages12
JournalThe Lancet Infectious Diseases
Volume10
Issue number11
DOIs
StatePublished - Nov 2010

Fingerprint Dive into the research topics of 'Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions'. Together they form a unique fingerprint.

Cite this