The immunopathogenesis of cryptococcal immune reconstitution inflammatory syndrome: understanding a conundrum.

ABSTRACT:

Purpose of review

Cryptococcal meningitis causes significant mortality among HIV-infected patients, despite antifungal therapy and use of antiretroviral therapy (ART). In patients with cryptococcal meningitis, ART is often complicated by immune reconstitution inflammatory syndrome (IRIS), manifesting as unmasking of previously unrecognized subclinical infection (unmasking CM-IRIS) or paradoxical worsening of symptoms in the central nervous system after prior improvement with antifungal therapy (paradoxical CM-IRIS). We review our current understanding of the pathogenesis of this phenomenon, focusing on unifying innate and adaptive immune mechanisms leading to the development of this often fatal syndrome.

Recent findings

We propose that HIV-associated CD4 T-cell depletion, ch

SUBMITTER: Meya DB 

PROVIDER: S-EPMC4689618 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature