Predicting IRIS in HIV-Related Cryptococcal Meningitis

Among a cohort of HIV-infected, ART-naive persons with cryptococcal meningitis, immune reconstitution inflammatory syndrome was more common in those with lower cryptococcal-specific antibody levels.

Cryptococcal immune reconstitution inflammatory syndrome (C-IRIS) occurs in up to 20% of HIV-infected persons with cryptococcal meningitis (CM) after the start of antiretroviral therapy (ART). Currently recognized risk factors for C-IRIS include an initially high cryptococcal burden in the cerebrospinal fluid (CSF), a lack of CSF inflammation, and a poor CD4+ T-cell count recovery after the start of ART. There are data supporting a role of specific antibody response in CM, but no published associations between antibody response and C-IRIS.

To examine this further, researchers obtained samples from an established cohort of 153 South African HIV-infected, ART-naive persons who had a first episode of CM. Ninety subjects subsequently developed C…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Predicting IRIS in HIV-Related Cryptococcal Meningitis

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Reviewing Author