Therapy Insight: CNS manifestations of HIV-associated immune reconstitution inflammatory syndrome

David J. Riedel, Carlos A. Pardo, Justin McArthur, Avindra Nath

Research output: Contribution to journalReview articlepeer-review

Abstract

The introduction of combination antiretroviral therapy for HIV infection has prolonged the lives of patients with AIDS. It is increasingly being recognized, however, that following initiation of this therapy some patients can develop a paradoxical neurological deterioration, despite dramatic improvements in HIV viral load and CD4+ T-cell counts. This immune reconstitution inflammatory syndrome (IRIS) in the CNS is emerging as an important neurological complication, particularly as antiretroviral therapy is now becoming readily available worldwide. Currently, there are no guidelines for prevention, diagnosis or treatment of the CNS manifestations of IRIS. Even in patients with an acute presentation, the diagnosis can be challenging. Furthermore, it is possible that more-chronic forms of the syndrome exist but remain unrecognized. Here, we review the various clinical presentations of CNS IRIS, and discuss options for their management.

Original languageEnglish (US)
Pages (from-to)557-565
Number of pages9
JournalNature Clinical Practice Neurology
Volume2
Issue number10
DOIs
StatePublished - Oct 2006

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience

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