Immunology Case Reports

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +1 (202) 780-3397

Mini Review - Immunology Case Reports (2023) Volume 6, Issue 2

A Complication of Immune-Recovery Therapy in People with Weakened Immune Systems

Charlotte Cary*

Department of Infectious Disease, Kings College, London, United States

*Corresponding Author:
Charlotte Cary
Department of Infectious Disease
Kings College, London
United States
E-mail:Charlottec@kcl.ac.uk

Received:31-Mar-2023, Manuscript No. AAICR-23-97433; Editor assigned:03-Apr-2023, PreQC No. AAICR-23-97433(PQ); Reviewed:17-Apr-2023, QC No. AAICR-23-97433; Revised:22-Apr-2023, Manuscript No. AAICR-23-97433(R); Published:29-Apr-2023, DOI:10.35841/aaicr-6.2.145

Citation: Cary C. A Complication of Immune-Recovery Therapy in People with Weakened Immune Systems. Immunol Case Rep. 2023;6(2):145

Visit for more related articles at Immunology Case Reports

Abstract

Immune reconstitution inflammatory syndrome (IRIS) is a condition that can occur in people with weakened immune systems undergoing immune-recovery therapy. It is caused by an exaggerated immune response to previously unnoticed or weak infections, leading to inflammation and tissue damage. IRIS can manifest in different ways depending on the underlying condition, and the treatment may involve anti-inflammatory drugs or adjustments to the immune-recovery therapy. Preventing IRIS can be challenging, but starting immune-recovery therapy gradually and monitoring patients closely for signs of IRIS can help to identify and treat the condition early. IRIS is a complex condition, and healthcare providers must be aware of the risk factors and potential symptoms to provide early identification and management.

Keywords

IRIS, Immune-recovery therapy, Weakened immune system, Inflammation, Tissue damage, Anti-inflammatory drugs, HIV.

Introduction

Immune reconstitution inflammatory syndrome (IRIS) is a condition that can occur in people with weakened immune systems, such as those who have undergone transplantation or those living with HIV. IRIS occurs when the immune system begins to recover and overreacts to previously unnoticed or harmless infections, causing inflammation and tissue damage [1].

The immune system is responsible for protecting the body against harmful pathogens, such as bacteria and viruses. In people with weakened immune systems, the body's ability to fight off infections is compromised. When these individuals receive treatment to boost their immune system, such as antiretroviral therapy (ART) for HIV or immunosuppressive drugs after a transplant, the immune system can become overactive. IRIS can manifest in different ways depending on the underlying condition and the location of the infection. For example, in people with HIV, IRIS may cause enlarged lymph nodes, fever, rash, or lung inflammation, while in transplant recipients; IRIS may cause skin lesions, organ dysfunction, or graft rejection. The symptoms typically develop within a few weeks to months after starting immune-recovery therapy and can range from mild to severe. The exact cause of IRIS is not fully understood, but it is thought to be due to an exaggerated immune response to previously unnoticed or weak infections. As the immune system becomes stronger, it can recognize and attack infections that were previously undetected, leading to an inflammatory response. The treatment of IRIS depends on the severity of symptoms and the underlying condition. In mild cases, symptoms may resolve on their own without intervention. In more severe cases, treatment may involve the use of anti-inflammatory drugs, such as corticosteroids, to reduce inflammation and prevent further tissue damage. In some cases, it may be necessary to interrupt or adjust the immune-recovery therapy to prevent further exacerbation of symptoms [2].

Preventing IRIS can be challenging, as it is difficult to predict who will develop the condition. However, some measures can be taken to reduce the risk of developing IRIS. For example, starting immune-recovery therapy gradually and monitoring patients closely for signs of IRIS can help to identify and treat the condition early. Additionally, treating any underlying infections before starting immune-recovery therapy can reduce the risk of developing IRIS [3].

IRIS is a condition that can occur in people with weakened immune systems undergoing immune-recovery therapy. It is caused by an exaggerated immune response to previously unnoticed or weak infections and can manifest in different ways depending on the underlying condition. While treatment for IRIS may vary, early identification and management of symptoms can help to prevent further tissue damage and improve patient outcomes. IRIS is most commonly associated with HIV, but it can also occur in other conditions that cause immunosuppression, such as cancer, autoimmune disorders, and genetic disorders. In these conditions, IRIS can develop as the immune system recovers following treatment for the underlying condition. One of the challenges in managing IRIS is differentiating it from other conditions that can cause similar symptoms. For example, in people with HIV, IRIS may be mistaken for an opportunistic infection, such as tuberculosis or cryptococcal meningitis. It is important for healthcare providers to consider IRIS as a potential cause of symptoms in people undergoing immune-recovery therapy, especially if they have a history of immunosuppression [4].

Another challenge is determining when to start immune-recovery therapy in people with weakened immune systems. Delaying treatment can lead to a higher risk of opportunistic infections, while starting treatment too early can increase the risk of developing IRIS. Healthcare providers must carefully balance the risks and benefits of immune-recovery therapy for each individual patient. There are also some factors that may increase the risk of developing IRIS. For example, people with a low CD4 cell count at the time of starting immune-recovery therapy may be at a higher risk of developing IRIS. Additionally, people who have had a previous episode of IRIS may be more likely to develop the condition again [5].

Conclusion

IRIS is a complex condition that can occur in people with weakened immune systems undergoing immune-recovery therapy. Healthcare providers must be aware of the risk factors and potential symptoms of IRIS to provide early identification and management. By carefully balancing the risks and benefits of immune-recovery therapy, healthcare providers can help to minimize the risk of IRIS and improve patient outcomes.

References

  1. Anderson AM, Mosunjac MB, Palmore MP, et al. Development of fatal acute liver failure in HIV-HBV coinfected patients. World J Gastroenterol. 2010;16(32):4107-11.

    2. Indexed at, Google Scholar,Cross Ref

  2. Post MJ, Thurnher MM, Clifford DB, et al. CNS-immune reconstitution inflammatory syndrome in the setting of HIV infection, part 2: discussion of neuro-immune reconstitution inflammatory syndrome with and without other pathogens. Am J Neuroradiol. 2013;34(7):1308-18.

    3. Indexed at, Google Scholar, Cross Ref

  3. Giacomini PS, Rozenberg A, Metz I, et al. Maraviroc in Multiple Sclerosis–Associated PML–IRIS (MIMSAPI) Group Maraviroc and JC virus-associated immune reconstitution inflammatory syndrome. N Engl J Med. 2014;370(5):486-88.

    4. Indexed at, Google Scholar, Cross Ref

  4. Perfect JR, Dismukes WE, Dromer F, et al. . Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2010;50(3):291–322.

    5. Indexed at, Google Scholar, Cross Ref

  5. Parkes-Ratanshi R, Wakeham K, Levin J, et al. Primary prophylaxis of cryptococcal disease with fluconazole in HIV-positive Ugandan adults: a double-blind, randomised, placebo-controlled trial. Lancet Infect Dis. 2011;11(12):933-41.

    6. Indexed at, Google Scholar, Cross Ref

Get the App