Objective: To describe incidence of immune reconstitution inflammatory syndrome (IRIS) and its association with mortality in a large multisite US HIV-infected cohort applying an objective, comprehensive definition. Design: We studied 2 610 patients seen during 1996–2007 who initiated or resumed highly active combination antiretroviral therapy (cART) and, during the next 6 months, demonstrated a decline in plasma HIV-RNA viral load of at least 0.5 log10 copies/ml or an increase of at least 50% in CD4 cell count per microliter. We defined IRIS as the diagnosis of a type B or C condition [as per the Centers for Disease Control and Prevention (CDC) 1993 AIDS case definition] or any new mucocutaneous disorder during this same 6-month period. Methods: We assessed the incidence of IRIS and evaluated risk factors for IRIS using conditional logistic regression and for all-cause mortality using proportional hazards models. Results: We identified 370 cases of IRIS (in 276 patients). Median and nadir CD4 cell counts at cART initiation were 90 and 43 cells/μl, respectively; median viral load was 2.7 log10 copies/ml. The most common IRIS-defining diagnoses were candidiasis (all forms), cytomegalovirus infection, disseminated Mycobacterium avium intracellulare, Pneumocystis pneumonia, varicella zoster, Kaposi's sarcoma and non-Hodgkin lymphoma. Only one case of Mycobacterium tuberculosis was observed. IRIS was independently associated with CD4 cell count less than 50 cells/μl vs. at least 200 cells/μl [odds ratio (OR) 5.0] and a viral load of at least 5.0 log10 copies vs. less than 4.0 log10 copies (OR 2.3). IRIS with a type B-defining or type C-defining diagnosis approximately doubled the risk for all-cause mortality. Conclusion: In this large US-based HIV-infected cohort, IRIS occurred in 10.6% of patients who responded to effective ART and contributed to increased mortality.

Richard M. Novak

James T. Richardson

Kate Buchacz

Joan S. Chmiel

Marcus D. Durham

Frank J. Palella

Andrea Wendrow

Kathy Wood

Benjamin Young

John T. Brooks

AIDS

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​被所有顶级临床医生和研究人员阅读，AIDS 在所有与 AIDS 相关的期刊中影响力最高。 AIDS 每年出版 18 期，保证以权威方式展示重大进展。编辑们本身就是著名的国际专家，他们了解您的工作需求，他们致力于使 AIDS 成为该领域最杰出和最具创新性的期刊。提交的文章将由编辑进行初步审查。有些文章可能会在没有进一步考虑的情况下退回给作者。那些被考虑出版的人将接受编辑的进一步评估和同行评审，以及那些被邀请从审稿人库中这样做的人。

AIDS is the most influential journal among all journals related to AIDS, widely read by top clinicians and researchers. The journal publishes 18 issues annually, aiming to present significant advancements in an authoritative manner. The editorial team consists of internationally recognized experts who understand the needs of researchers and strive to make AIDS the most distinguished and innovative journal in the field. All submitted articles will undergo an initial review by the editors, and some may be returned to authors without further consideration. Articles that are considered for publication will undergo further evaluation by the editors and peer review, conducted by invited reviewers.

《AIDS》是所有与艾滋病相关的期刊中影响力最高的期刊，受到顶级临床医生和研究人员的广泛阅读。该期刊每年出版18期，致力于以权威的方式展示重大进展。编辑团队由国际知名专家组成，他们了解研究者的需求，努力使《AIDS》成为该领域最杰出和最具创新性的期刊。所有提交的文章将经过编辑的初步审查，部分文章可能会在没有进一步考虑的情况下退回给作者。那些被考虑出版的文章将接受编辑的进一步评估和同行评审，评审工作将由邀请的审稿人进行。

Immune reconstitution inflammatory syndrome

In this large US-based HIV-infected cohort, IRIS occurred in 10.6% of patients who responded to effective ART and contributed to increased mortality and approximately doubled the risk for all-cause mortality.

Category	Quartile
医学	2
医学, 免疫学	2
医学, 传染病学	2
医学, 病毒学	2

Immune reconstitution inflammatory syndrome

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