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 journalArticle

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
JournalLancet Infectious Diseases
Volume10
Issue number11
DOIs
StatePublished - Nov 2010

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Immune Reconstitution Inflammatory Syndrome
HIV-1
Cryptococcosis
Cryptococcus
Therapeutics
Epidemiologic Studies
Tuberculosis

ASJC Scopus subject areas

  • Infectious Diseases

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Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals : proposed clinical case definitions. / Haddow, Lewis J.; Colebunders, Robert; Meintjes, Graeme; Lawn, Stephen D.; Elliott, Julian H.; Manabe, Yukari C; Bohjanen, Paul R.; Sungkanuparph, Somnuek; Easterbrook, Philippa J.; French, Martyn A.; Boulware, David R.

In: Lancet Infectious Diseases, Vol. 10, No. 11, 11.2010, p. 791-802.

Research output: Contribution to journalArticle

Haddow, LJ, Colebunders, R, Meintjes, G, Lawn, SD, Elliott, JH, Manabe, YC, Bohjanen, PR, Sungkanuparph, S, Easterbrook, PJ, French, MA & Boulware, DR 2010, 'Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions', Lancet Infectious Diseases, vol. 10, no. 11, pp. 791-802. https://doi.org/10.1016/S1473-3099(10)70170-5
Haddow, Lewis J. ; Colebunders, Robert ; Meintjes, Graeme ; Lawn, Stephen D. ; Elliott, Julian H. ; Manabe, Yukari C ; Bohjanen, Paul R. ; Sungkanuparph, Somnuek ; Easterbrook, Philippa J. ; French, Martyn A. ; Boulware, David R. / Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals : proposed clinical case definitions. In: Lancet Infectious Diseases. 2010 ; Vol. 10, No. 11. pp. 791-802.
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