Strongyloides stercoralis Infection as a Manifestation of Immune Restoration Syndrome

Kim, Angela C.; Lupatkin, Helene

doi:10.1086/422522

Cited by 34 publications

(36 citation statements)

References 5 publications

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“…Four possible cases of unmasking IRIS [70][71][72][73] and one case of paradoxical IRIS [74] associated with Strongyloides stercoralis have been described. The median baseline CD4 count was 48 cells/μL.…”

Section: Strongyloides Stercoralismentioning

confidence: 99%

The immune reconstitution inflammatory syndrome related to HIV co-infections: a review

Veld

Sun

Hung

et al. 2011

Eur J Clin Microbiol Infect Dis

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The immune reconstitution inflammatory syndrome (IRIS) is a consequence of an excessive pathogen-specific immune recovery reaction and occurs in a subset of patients on antiretroviral therapy (ART). Infective forms of IRIS may present either as an 'unmasking' of a previously subclinical infection or the paradoxical clinical deterioration of an infection for which the patient received appropriate antimicrobial therapy. The most important risk factors for IRIS are a low CD4+ T-cell count and a short time between treatment of the infection and the commencement of ART. The general approach to the treatment of IRIS is to continue ART and provide antimicrobial therapy for the provoking infection. The majority of cases are self-limiting; however, mortality and hospitalisation rates are particularly high when tuberculosis- or cryptococcal-IRIS affects the central nervous system (CNS). Corticosteroid therapy should be considered in certain forms of IRIS after the exclusion of other conditions that could explain the inflammatory manifestations in the patients. Given that a low CD4+ T-cell count is a major risk factor for the development of IRIS, commencing ART at a CD4+ T-cell count of >350/μL will prevent most cases.

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Section: Strongyloides Stercoralismentioning

confidence: 99%

The immune reconstitution inflammatory syndrome related to HIV co-infections: a review

Veld

Sun

Hung

et al. 2011

Eur J Clin Microbiol Infect Dis

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“…These manifestations are consistent with our understanding of the disorder of Schistosoma mansoni infection, which results from host granulomatous inflammation in response to schistosomal eggs within the colonic mucosa. Several case reports have also reported Strongyloides stercoralis infection to be associated with IRD, with manifestations including fever, eosinophilia, hepatitis, pulmonary infiltrates and gastrointestinal symptoms [47][48][49][50]. Three of these cases had also received corticosteroids; this is a well established risk factor in patients with sub-clinical strongyloidiasis and it has been questioned whether such cases truly represent IRD [51].…”

Section: Parasitic Infections and Immune Reconstitution Diseasementioning

confidence: 99%

Immune reconstitution disease: recent developments and implications for antiretroviral treatment in resource-limited settings

Lawn

French²

2007

Current Opinion in HIV and AIDS

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“…Both had CD4 counts of less than 200/ml, and their disease was interpreted as a form of IRIS [56]. Newly described forms of IRIS include pneumonia with M. xenopi concurrent with granulomatous Pneumocystis jiroveci pneumonia [57], and pulmonary strongyloidiasis [58,59]. IRIS associated with preexistent Kaposi sarcoma has been described recently, including a fatal outcome in a patient with previously undiagnosed visceral Kaposi sarcoma [60,61].…”

Section: Miscellaneous Causesmentioning

confidence: 99%

Clinical spectrum of the immune restoration inflammatory syndrome

Battegay

Drechsler

2006

Current Opinion in HIV and AIDS

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It is important to consider immune reconstitution inflammatory syndrome particularly in patients who are started later on antiretroviral therapy. As HIV-infected patients who present late in their disease course are at risk, consideration of this syndrome is particularly important for developing countries where antiretroviral therapy is often prescribed for patients who already have advanced immunodeficiency.

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Strongyloides stercoralis Infection as a Manifestation of Immune Restoration Syndrome

Cited by 34 publications

References 5 publications

The immune reconstitution inflammatory syndrome related to HIV co-infections: a review

The immune reconstitution inflammatory syndrome related to HIV co-infections: a review

Immune reconstitution disease: recent developments and implications for antiretroviral treatment in resource-limited settings

Clinical spectrum of the immune restoration inflammatory syndrome

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