Journal
NATURE REVIEWS MICROBIOLOGY
Volume 10, Issue 2, Pages 150-156Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/nrmicro2712
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Funding
- US National Institute for Allergy and Infectious Diseases, National Institutes of Health
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Some individuals who are infected with HIV rapidly deteriorate shortly after starting antiretroviral therapy, despite effective viral suppression. This reaction, referred to as immune reconstitution inflammatory syndrome ( IRIS), is characterized by tissue-destructive inflammation and arises as CD4(+) T cells re-emerge. It has been proposed that IRIS is caused by a dysregulation of the expanding population of CD4(+) T cells specific for a co-infecting opportunistic pathogen. Here, we argue that IRIS instead results from hyper-responsiveness of the innate immune system to T cell help, a mechanism that may be shared by the many manifestations of IRIS that occur following the reversal of other types of immunosuppression in pathogen-infected hosts.
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