Immune Reconstitution Syndrome in HIV: Validating a Case Definition and Identifying Clinical Predictors in Persons Initiating Antiretroviral Therapy
Background. Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for immune reconstitution syndrome. The objectives of this study were to validate a proposed definition and to identify factors predictive of immu...
Saved in:
| Published in | Clinical infectious diseases Vol. 42; no. 11; pp. 1639 - 1646 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Chicago, IL
The University of Chicago Press
01.06.2006
University of Chicago Press Oxford University Press |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1058-4838 1537-6591 1537-6591 |
| DOI | 10.1086/503903 |
Cover
Loading…
| Abstract | Background. Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for immune reconstitution syndrome. The objectives of this study were to validate a proposed definition and to identify factors predictive of immune reconstitution syndrome. Methods. This was a retrospective case-control study from an academic university medical practice. Cases were matched to ⩾2 control subjects by CD4+ cell count at the time of initiation of antiretroviral therapy. Cases and “mock cases” were blindly reviewed by 2 human immunodeficiency virus (HIV) experts. Results. Twenty possible cases of immune reconstitution syndrome were identified; HIV experts excluded all cases of herpes zoster (shingles), with agreement on real and mock cases of 92%. For 14 confirmed case patients (compared with 40 control subjects), immune reconstitution syndrome was associated with a higher number of prior opportunistic infections (P = .003) and higher CD8+ cell counts at baseline (P = .05) and at week 12 (P = .02). Immune reconstitution syndrome was associated with lower baseline levels of alanine aminotransferase (P = .05) and hemoglobin (P = .02). On multivariate analysis, the number of prior opportunistic infections (odds ratio, 2.7; P = .007) and lower hemoglobin level at baseline (odds ratio, 0.8; P = .003) were independently associated with development of immune reconstitution syndrome. A predictive model was defined by classification and regression tree analysis with a sensitivity and specificity of 78.57% and 87.50%, respectively, for an importance score of ⩾4 (on a scale of 0.0 to 100.0), and 92.86% and 80.00%, respectively, for a score of ⩾2, using the number of prior opportunistic infections, CD8+ cell count, and hemoglobin level. Conclusions. A standard definition for immune reconstitution syndrome is possible. Patients with a greater severity of illness at initiation of antiretroviral therapy are at risk for immune reconstitution syndrome. The model defined by classification and regression tree analysis may provide a basis for risk stratification before initiation of antiretroviral therapy. |
|---|---|
| AbstractList | Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for immune reconstitution syndrome. The objectives of this study were to validate a proposed definition and to identify factors predictive of immune reconstitution syndrome.
This was a retrospective case-control study from an academic university medical practice. Cases were matched to > or =2 control subjects by CD4+ cell count at the time of initiation of antiretroviral therapy. Cases and "mock cases" were blindly reviewed by 2 human immunodeficiency virus (HIV) experts.
Twenty possible cases of immune reconstitution syndrome were identified; HIV experts excluded all cases of herpes zoster (shingles), with agreement on real and mock cases of 92%. For 14 confirmed case patients (compared with 40 control subjects), immune reconstitution syndrome was associated with a higher number of prior opportunistic infections (P=.003) and higher CD8+ cell counts at baseline (P=.05) and at week 12 (P=.02). Immune reconstitution syndrome was associated with lower baseline levels of alanine aminotransferase (P=.05) and hemoglobin (P=.02). On multivariate analysis, the number of prior opportunistic infections (odds ratio, 2.7; P=.007) and lower hemoglobin level at baseline (odds ratio, 0.8; P=.003) were independently associated with development of immune reconstitution syndrome. A predictive model was defined by classification and regression tree analysis with a sensitivity and specificity of 78.57% and 87.50%, respectively, for an importance score of > or =4 (on a scale of 0.0 to 100.0), and 92.86% and 80.00%, respectively, for a score of > or =2, using the number of prior opportunistic infections, CD8+ cell count, and hemoglobin level.
A standard definition for immune reconstitution syndrome is possible. Patients with a greater severity of illness at initiation of antiretroviral therapy are at risk for immune reconstitution syndrome. The model defined by classification and regression tree analysis may provide a basis for risk stratification before initiation of antiretroviral therapy. Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for immune reconstitution syndrome. The objectives of this study were to validate a proposed definition and to identify factors predictive of immune reconstitution syndrome. This was a retrospective case-control study from an academic university medical practice. Cases were matched to ≥2 control subjects by CD4^sup +^ cell count at the time of initiation of antiretroviral therapy. Cases and "mock cases" were blindly reviewed by 2 human immunodeficiency virus (HIV) experts. Twenty possible cases of immune reconstitution syndrome were identified; HIV experts excluded all cases of herpes zoster (shingles), with agreement on real and mock cases of 92%. For 14 confirmed case patients (compared with 40 control subjects), immune reconstitution syndrome was associated with a higher number of prior opportunistic infections (P = .003) and higher CD8^sup +^ cell counts at baseline (P = .05) and at week 12 (P = .02). Immune reconstitution syndrome was associated with lower baseline levels of alanine aminotransferase (P = .05) and hemoglobin (P = .02). On multivariate analysis, the number of prior opportunistic infections (odds ratio, 2.7; P = .007) and lower hemoglobin level at baseline (odds ratio, 0.8; P = .003) were independently associated with development of immune reconstitution syndrome. A predictive model was defined by classification and regression tree analysis with a sensitivity and specificity of 78.57% and 87.50%, respectively, for an importance score of ≥4 (on a scale of 0.0 to 100.0), and 92.86% and 80.00%, respectively, for a score of ≥2, using the number of prior opportunistic infections, CD8^sup +^ cell count, and hemoglobin level. A standard definition for immune reconstitution syndrome is possible. Patients with a greater severity of illness at initiation of antiretroviral therapy are at risk for immune reconstitution syndrome. The model defined by classification and regression tree analysis may provide a basis for risk stratification before initiation of antiretroviral therapy. Background . Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for immune reconstitution syndrome. The objectives of this study were to validate a proposed definition and to identify factors predictive of immune reconstitution syndrome. Methods . This was a retrospective case-control study from an academic university medical practice. Cases were matched to ⩾2 control subjects by CD4+ cell count at the time of initiation of antiretroviral therapy. Cases and "mock cases" were blindly reviewed by 2 human immunodeficiency virus (HIV) experts. Results . Twenty possible cases of immune reconstitution syndrome were identified; HIV experts excluded all cases of herpes zoster (shingles), with agreement on real and mock cases of 92%. For 14 confirmed case patients (compared with 40 control subjects), immune reconstitution syndrome was associated with a higher number of prior opportunistic infections (P = .003) and higher CD8+ cell counts at baseline (P = .05) and at week 12 (P = .02). Immune reconstitution syndrome was associated with lower baseline levels of alanine aminotransferase (P = .05) and hemoglobin (P = .02). On multivariate analysis, the number of prior opportunistic infections (odds ratio, 2.7; P = .007) and lower hemoglobin level at baseline (odds ratio, 0.8; P = .003) were independently associated with development of immune reconstitution syndrome. A predictive model was defined by classification and regression tree analysis with a sensitivity and specificity of 78.57% and 87.50%, respectively, for an importance score of ⩾4 (on a scale of 0.0 to 100.0), and 92.86% and 80.00%, respectively, for a score of ⩾2, using the number of prior opportunistic infections, CD8+ cell count, and hemoglobin level. Conclusions . A standard definition for immune reconstitution syndrome is possible. Patients with a greater severity of illness at initiation of antiretroviral therapy are at risk for immune reconstitution syndrome. The model defined by classification and regression tree analysis may provide a basis for risk stratification before initiation of antiretroviral therapy. Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for immune reconstitution syndrome. The objectives of this study were to validate a proposed definition and to identify factors predictive of immune reconstitution syndrome.BACKGROUNDClinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for immune reconstitution syndrome. The objectives of this study were to validate a proposed definition and to identify factors predictive of immune reconstitution syndrome.This was a retrospective case-control study from an academic university medical practice. Cases were matched to > or =2 control subjects by CD4+ cell count at the time of initiation of antiretroviral therapy. Cases and "mock cases" were blindly reviewed by 2 human immunodeficiency virus (HIV) experts.METHODSThis was a retrospective case-control study from an academic university medical practice. Cases were matched to > or =2 control subjects by CD4+ cell count at the time of initiation of antiretroviral therapy. Cases and "mock cases" were blindly reviewed by 2 human immunodeficiency virus (HIV) experts.Twenty possible cases of immune reconstitution syndrome were identified; HIV experts excluded all cases of herpes zoster (shingles), with agreement on real and mock cases of 92%. For 14 confirmed case patients (compared with 40 control subjects), immune reconstitution syndrome was associated with a higher number of prior opportunistic infections (P=.003) and higher CD8+ cell counts at baseline (P=.05) and at week 12 (P=.02). Immune reconstitution syndrome was associated with lower baseline levels of alanine aminotransferase (P=.05) and hemoglobin (P=.02). On multivariate analysis, the number of prior opportunistic infections (odds ratio, 2.7; P=.007) and lower hemoglobin level at baseline (odds ratio, 0.8; P=.003) were independently associated with development of immune reconstitution syndrome. A predictive model was defined by classification and regression tree analysis with a sensitivity and specificity of 78.57% and 87.50%, respectively, for an importance score of > or =4 (on a scale of 0.0 to 100.0), and 92.86% and 80.00%, respectively, for a score of > or =2, using the number of prior opportunistic infections, CD8+ cell count, and hemoglobin level.RESULTSTwenty possible cases of immune reconstitution syndrome were identified; HIV experts excluded all cases of herpes zoster (shingles), with agreement on real and mock cases of 92%. For 14 confirmed case patients (compared with 40 control subjects), immune reconstitution syndrome was associated with a higher number of prior opportunistic infections (P=.003) and higher CD8+ cell counts at baseline (P=.05) and at week 12 (P=.02). Immune reconstitution syndrome was associated with lower baseline levels of alanine aminotransferase (P=.05) and hemoglobin (P=.02). On multivariate analysis, the number of prior opportunistic infections (odds ratio, 2.7; P=.007) and lower hemoglobin level at baseline (odds ratio, 0.8; P=.003) were independently associated with development of immune reconstitution syndrome. A predictive model was defined by classification and regression tree analysis with a sensitivity and specificity of 78.57% and 87.50%, respectively, for an importance score of > or =4 (on a scale of 0.0 to 100.0), and 92.86% and 80.00%, respectively, for a score of > or =2, using the number of prior opportunistic infections, CD8+ cell count, and hemoglobin level.A standard definition for immune reconstitution syndrome is possible. Patients with a greater severity of illness at initiation of antiretroviral therapy are at risk for immune reconstitution syndrome. The model defined by classification and regression tree analysis may provide a basis for risk stratification before initiation of antiretroviral therapy.CONCLUSIONSA standard definition for immune reconstitution syndrome is possible. Patients with a greater severity of illness at initiation of antiretroviral therapy are at risk for immune reconstitution syndrome. The model defined by classification and regression tree analysis may provide a basis for risk stratification before initiation of antiretroviral therapy. Background. Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for immune reconstitution syndrome. The objectives of this study were to validate a proposed definition and to identify factors predictive of immune reconstitution syndrome. Methods. This was a retrospective case-control study from an academic university medical practice. Cases were matched to ⩾2 control subjects by CD4+ cell count at the time of initiation of antiretroviral therapy. Cases and “mock cases” were blindly reviewed by 2 human immunodeficiency virus (HIV) experts. Results. Twenty possible cases of immune reconstitution syndrome were identified; HIV experts excluded all cases of herpes zoster (shingles), with agreement on real and mock cases of 92%. For 14 confirmed case patients (compared with 40 control subjects), immune reconstitution syndrome was associated with a higher number of prior opportunistic infections (P = .003) and higher CD8+ cell counts at baseline (P = .05) and at week 12 (P = .02). Immune reconstitution syndrome was associated with lower baseline levels of alanine aminotransferase (P = .05) and hemoglobin (P = .02). On multivariate analysis, the number of prior opportunistic infections (odds ratio, 2.7; P = .007) and lower hemoglobin level at baseline (odds ratio, 0.8; P = .003) were independently associated with development of immune reconstitution syndrome. A predictive model was defined by classification and regression tree analysis with a sensitivity and specificity of 78.57% and 87.50%, respectively, for an importance score of ⩾4 (on a scale of 0.0 to 100.0), and 92.86% and 80.00%, respectively, for a score of ⩾2, using the number of prior opportunistic infections, CD8+ cell count, and hemoglobin level. Conclusions. A standard definition for immune reconstitution syndrome is possible. Patients with a greater severity of illness at initiation of antiretroviral therapy are at risk for immune reconstitution syndrome. The model defined by classification and regression tree analysis may provide a basis for risk stratification before initiation of antiretroviral therapy. Background. Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for immune reconstitution syndrome. The objectives of this study were to validate a proposed definition and to identify factors predictive of immune reconstitution syndrome. Methods. This was a retrospective case-control study from an academic university medical practice. Cases were matched to ≥2 control subjects by CD4⁺ cell count at the time of initiation of antiretroviral therapy. Cases and "mock cases" were blindly reviewed by 2 human immunodeficiency virus (HIV) experts. Results. Twenty possible cases of immune reconstitution syndrome were identified; HIV experts excluded all cases of herpes zoster (shingles), with agreement on real and mock cases of 92%. For 14 confirmed case patients (compared with 40 control subjects), immune reconstitution syndrome was associated with a higher number of prior opportunistic infections (P = .003) and higher CD8⁺ cell counts at baseline (P = .05) and at week 12 (P = .02). Immune reconstitution syndrome was associated with lower baseline levels of alanine aminotransferase (P = .05) and hemoglobin (P = .02). On multivariate analysis, the number of prior opportunistic infections (odds ratio, 2.7; P = .007) and lower hemoglobin level at baseline (odds ratio, 0.8; P = .003) were independently associated with development of immune reconstitution syndrome. A predictive model was defined by classification and regression tree analysis with a sensitivity and specificity of 78.57% and 87.50%, respectively, for an importance score of ≥4 (on a scale of 0.0 to 100.0), and 92.86% and 80.00%, respectively, for a score of ≥2, using the number of prior opportunistic infections, CD8⁺ cell count, and hemoglobin level. Conclusions. A standard definition for immune reconstitution syndrome is possible. Patients with a greater severity of illness at initiation of antiretroviral therapy are at risk for immune reconstitution syndrome. The model defined by classification and regression tree analysis may provide a basis for risk stratification before initiation of antiretroviral therapy. |
| Author | Wall, Jennifer Ying, Jun Robertson, Jaime Fichtenbaum, Carl J. Meier, Matthew |
| Author_xml | – sequence: 1 givenname: Jaime surname: Robertson fullname: Robertson, Jaime email: roberj5@ucmail.uc.edu organization: Department of Internal Medicine, Division of Infectious Diseases, Cincinnati, Ohio – sequence: 2 givenname: Matthew surname: Meier fullname: Meier, Matthew organization: Department of Internal Medicine, Division of Infectious Diseases, Cincinnati, Ohio – sequence: 3 givenname: Jennifer surname: Wall fullname: Wall, Jennifer organization: Department of Internal Medicine, Division of Infectious Diseases, Cincinnati, Ohio – sequence: 4 givenname: Jun surname: Ying fullname: Ying, Jun organization: Institute for Health Statistics, University of Cincinnati College of Medicine, Cincinnati, Ohio – sequence: 5 givenname: Carl J. surname: Fichtenbaum fullname: Fichtenbaum, Carl J. organization: Department of Internal Medicine, Division of Infectious Diseases, Cincinnati, Ohio |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17923807$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/16652323$$D View this record in MEDLINE/PubMed |
| BookMark | eNp10d1uFCEUAOCJqbE_6hMYgyZ65SgMA8N4V9ef3aaJVWtjekNOgbGsM7ACY9z38IFlO3WbNPEKwvk4B87ZL3acd6YoHhL8kmDBXzFMW0zvFHuE0abkrCU7eY-ZKGtBxW6xH-MSY0IEZveKXcI5q2hF94o_i2EYnUGfjfIuJpvGZL1DX9ZOBz8YZB2aL85eozPorYZk3XcEaAbRoLems85eaXAaLbRxyXbrjZj1OaKgRyfBaKuSD3GT6MSEmIugxebalOsw3wkmBf_LhuxPL02A1fp-cbeDPpoH1-tB8fX9u9PZvDz--GExOzwuVc1IKkFpReqq5qrWjJjK1GAafVFz0THNO9Uw4ATyGcNAqcGMEY0ZB61arjQAPSieT3lXwf8cTUxysFGZvgdn_Bglb9qKVzXL8OktuPRjcPltsiJty4ggPKPH12i8GIyWq2AHCGv5r9kZPLsGEHN3ugBO2XjjcjUqcJPdi8mp4GMMppPKJth0OgWwvSRYbmYup5nf_GLLtxlvwycT9OPq_-bRZJYxj22r6lrU4ipcTmEbk_m9DUP4kZtFGybn387luThqjt5Un-SM_gWtmM4e |
| CODEN | CIDIEL |
| CitedBy_id | crossref_primary_10_1371_journal_pone_0116526 crossref_primary_10_1111_j_1365_2230_2009_03621_x crossref_primary_10_1111_odi_13402 crossref_primary_10_1097_QAI_0b013e3181594c8c crossref_primary_10_1093_cid_cis529 crossref_primary_10_1186_s12981_016_0106_y crossref_primary_10_1097_RTI_0b013e318149e808 crossref_primary_10_1007_s13546_013_0700_4 crossref_primary_10_1007_s15010_013_0504_1 crossref_primary_10_1016_j_ijid_2011_02_007 crossref_primary_10_1258_ijsa_2007_007163 crossref_primary_10_2169_internalmedicine_47_0893 crossref_primary_10_1371_journal_pone_0040623 crossref_primary_10_1016_j_ncl_2009_09_018 crossref_primary_10_1097_QAI_0000000000001397 crossref_primary_10_1097_COH_0b013e3282fe6e84 crossref_primary_10_1002_cncr_22738 crossref_primary_10_2214_AJR_07_2458 crossref_primary_10_1097_INF_0000000000000142 crossref_primary_10_1016_j_eimc_2009_03_007 crossref_primary_10_1002_pbc_22143 crossref_primary_10_1186_1476_9255_10_21 crossref_primary_10_1093_cid_cit341 crossref_primary_10_1007_s15010_008_8134_8 crossref_primary_10_1007_s11908_012_0308_y crossref_primary_10_1590_abd1806_4841_20142998 crossref_primary_10_1053_j_seminhematol_2009_03_002 crossref_primary_10_1097_NEN_0b013e318181b4da crossref_primary_10_1258_ijsa_2010_010135 crossref_primary_10_1111_j_1439_0507_2010_01870_x crossref_primary_10_1007_s11046_017_0230_9 crossref_primary_10_1097_QAD_0b013e32832ec1f4 crossref_primary_10_1016_S0123_9392_12_70027_9 crossref_primary_10_2165_11587420_000000000_00000 crossref_primary_10_1016_j_adengl_2012_06_032 crossref_primary_10_1111_hiv_13192 crossref_primary_10_1902_jop_2008_070225 crossref_primary_10_1086_595894 crossref_primary_10_1097_QAI_0b013e3181609da8 crossref_primary_10_1016_j_ijtb_2023_09_002 crossref_primary_10_1179_acb_2007_022 crossref_primary_10_1093_heapol_czz072 crossref_primary_10_1111_odi_13391 crossref_primary_10_1177_1545109711408316 crossref_primary_10_1097_RHU_0b013e3181c78ddc crossref_primary_10_1002_lary_25470 crossref_primary_10_2217_17520363_2_4_349 crossref_primary_10_1093_cid_ciy242 crossref_primary_10_1586_eri_12_62 crossref_primary_10_1097_MCP_0b013e328344f692 crossref_primary_10_5005_jp_journals_11007_0118 crossref_primary_10_1111_j_1365_4632_2007_03520_x crossref_primary_10_1016_j_jve_2021_100052 crossref_primary_10_1186_s12879_017_2700_6 crossref_primary_10_1056_NEJMoa0708975 crossref_primary_10_1080_23744235_2018_1519639 crossref_primary_10_1097_QAI_0b013e3181bc476f crossref_primary_10_1177_0956462416654069 crossref_primary_10_1016_S1473_3099_08_70184_1 crossref_primary_10_1177_1545109709332469 crossref_primary_10_1097_QAD_0b013e3283511e91 crossref_primary_10_1055_a_1302_3530 crossref_primary_10_1016_j_optm_2010_07_030 crossref_primary_10_3389_fcimb_2022_962059 crossref_primary_10_1007_s11908_012_0311_3 crossref_primary_10_1186_s12879_024_10298_z crossref_primary_10_1258_ijsa_2009_008521 crossref_primary_10_22328_2079_5343_2020_11_1_38_45 crossref_primary_10_1097_QAD_0b013e3283614a8d crossref_primary_10_1099_jmmcr_0_005070 crossref_primary_10_1097_COH_0b013e328302ebbb crossref_primary_10_1097_QAI_0000000000000020 crossref_primary_10_1093_tropej_fmx052 crossref_primary_10_1177_2325957413488170 crossref_primary_10_1007_s00281_015_0532_2 crossref_primary_10_1097_QAD_0b013e3282a4a64d crossref_primary_10_1016_j_annfar_2011_03_016 crossref_primary_10_1016_j_clineuro_2012_01_020 crossref_primary_10_1016_j_ddmec_2007_11_001 crossref_primary_10_1186_s12981_019_0250_2 crossref_primary_10_1007_s13760_013_0185_7 crossref_primary_10_1177_1545109712457711 crossref_primary_10_2169_internalmedicine_55_6996 crossref_primary_10_3389_fimmu_2019_01800 crossref_primary_10_1186_s12879_020_4797_2 crossref_primary_10_1097_COH_0b013e328302ebd1 crossref_primary_10_1152_ajplung_00079_2006 crossref_primary_10_1016_j_jinf_2008_01_010 crossref_primary_10_1007_s12098_010_0330_8 crossref_primary_10_1097_INF_0b013e31827031aa crossref_primary_10_1097_QAD_0b013e32833b260a crossref_primary_10_1002_jcb_22147 crossref_primary_10_1093_cid_cir802 crossref_primary_10_1093_cid_ciz247 crossref_primary_10_1371_journal_pone_0011416 crossref_primary_10_1007_s00115_011_3298_3 crossref_primary_10_1016_j_riam_2015_09_001 crossref_primary_10_3390_medicina58010110 crossref_primary_10_1016_S2352_3018_14_70027_X crossref_primary_10_1097_QAD_0b013e3280117f94 crossref_primary_10_1097_QAD_0b013e3283477d67 crossref_primary_10_1016_j_tripleo_2007_02_001 crossref_primary_10_1016_S1473_3099_10_70170_5 crossref_primary_10_1186_s12879_020_4786_5 crossref_primary_10_4081_idr_2017_6884 crossref_primary_10_1258_ijsa_2009_009439 crossref_primary_10_2165_11591360_000000000_00000 crossref_primary_10_3174_ajnr_A2035 crossref_primary_10_1007_s00247_009_1192_y crossref_primary_10_1097_01_aids_0000432456_14099_c7 crossref_primary_10_1016_j_ccm_2013_01_004 crossref_primary_10_1517_14656566_2010_517195 crossref_primary_10_1016_j_ijid_2009_05_016 crossref_primary_10_1016_j_ad_2012_06_017 crossref_primary_10_1186_1750_9378_3_1 crossref_primary_10_1093_infdis_jiu051 crossref_primary_10_1016_j_ccc_2013_03_010 crossref_primary_10_1097_QAI_0b013e3181b1d6dc crossref_primary_10_1016_j_jctube_2016_03_002 crossref_primary_10_1111_j_1365_2796_2007_01795_x crossref_primary_10_1097_QAD_0000000000001599 crossref_primary_10_3341_kjo_2024_0133 crossref_primary_10_1186_1479_5876_5_50 crossref_primary_10_18273_revmed_v37n1_2024006 crossref_primary_10_1086_509645 crossref_primary_10_1016_j_ajpath_2017_08_035 crossref_primary_10_1080_25787489_2021_1975609 crossref_primary_10_1371_journal_pone_0217014 crossref_primary_10_3390_cancers14040986 crossref_primary_10_1086_509642 crossref_primary_10_1111_j_1365_2133_2009_09365_x crossref_primary_10_1212_01_wnl_0000343510_08643_74 crossref_primary_10_1378_chest_06_2871 crossref_primary_10_1097_ID9_0000000000000105 crossref_primary_10_1097_QAD_0b013e32832d9b20 crossref_primary_10_1038_ncpneuro0303 crossref_primary_10_1097_QCO_0b013e328352b664 crossref_primary_10_1378_chest_08_0364 crossref_primary_10_1016_S0140_6736_09_62101_2 crossref_primary_10_1258_ijsa_2012_012141 crossref_primary_10_3174_ajnr_A3184 crossref_primary_10_3174_ajnr_A3183 crossref_primary_10_1016_S1730_1270_10_60033_1 crossref_primary_10_1097_MD_0000000000018163 crossref_primary_10_1258_ijsa_2008_008428 crossref_primary_10_1016_S1473_3099_23_00482_6 crossref_primary_10_1586_ers_09_8 |
| Cites_doi | 10.1016/S0952-7915(97)80112-4 10.1097/00005792-200205000-00005 10.1097/00002030-199211000-00009 10.1086/383034 10.1046/j.1464-2662.2001.00096.x 10.1086/515019 10.1007/s00415-004-0563-4 10.1016/S1473-3099(05)70140-7 10.1097/01.aids.0000161769.06158.8a 10.1086/340636 10.1046/j.1365-2249.2001.01647.x 10.1046/j.1468-1293.2000.00012.x 10.1007/s00401-005-0983-y 10.1097/01.qai.0000178408.62675.b0 10.1093/jnlids/166.5.1153 10.1016/S0002-9343(01)00703-3 10.1086/425742 |
| ContentType | Journal Article |
| Copyright | Copyright 2006 The Infectious Diseases Society of America 2006 by the Infectious Diseases Society of America 2006 2006 INIST-CNRS Copyright University of Chicago, acting through its Press Jun 1, 2006 |
| Copyright_xml | – notice: Copyright 2006 The Infectious Diseases Society of America – notice: 2006 by the Infectious Diseases Society of America 2006 – notice: 2006 INIST-CNRS – notice: Copyright University of Chicago, acting through its Press Jun 1, 2006 |
| DBID | BSCLL AAYXX CITATION IQODW CGR CUY CVF ECM EIF NPM 7QL 7T2 7T7 7U7 7U9 8FD C1K FR3 H94 K9. M7N P64 7X8 |
| DOI | 10.1086/503903 |
| DatabaseName | Istex CrossRef Pascal-Francis Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed Bacteriology Abstracts (Microbiology B) Health and Safety Science Abstracts (Full archive) Industrial and Applied Microbiology Abstracts (Microbiology A) Toxicology Abstracts Virology and AIDS Abstracts Technology Research Database Environmental Sciences and Pollution Management Engineering Research Database AIDS and Cancer Research Abstracts ProQuest Health & Medical Complete (Alumni) Algology Mycology and Protozoology Abstracts (Microbiology C) Biotechnology and BioEngineering Abstracts MEDLINE - Academic |
| DatabaseTitle | CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) Virology and AIDS Abstracts Technology Research Database Toxicology Abstracts Bacteriology Abstracts (Microbiology B) Algology Mycology and Protozoology Abstracts (Microbiology C) AIDS and Cancer Research Abstracts ProQuest Health & Medical Complete (Alumni) Health & Safety Science Abstracts Engineering Research Database Industrial and Applied Microbiology Abstracts (Microbiology A) Biotechnology and BioEngineering Abstracts Environmental Sciences and Pollution Management MEDLINE - Academic |
| DatabaseTitleList | MEDLINE Virology and AIDS Abstracts MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1537-6591 |
| EndPage | 1646 |
| ExternalDocumentID | 1059107461 16652323 17923807 10_1086_503903 10.1086/503903 4484803 ark_67375_HXZ_Z8J7JB2Q_C |
| Genre | Journal Article Research Support, N.I.H., Extramural Feature |
| GrantInformation_xml | – fundername: NIAID NIH HHS grantid: AI-25897 |
| GroupedDBID | --- ..I .2P .GJ .I3 .ZR 08P 0R~ 1TH 29B 2AX 2WC 36B 4.4 48X 53G 5GY 5RE 5VS 5WD 6J9 AABZA AACGO AACZT AAJKP AAJQQ AAMVS AANCE AAOGV AAPQZ AAPXW AAQQT AARHZ AAUAY AAUQX AAVAP ABBHK ABDFA ABEJV ABEUO ABGNP ABIXL ABJNI ABLJU ABNGD ABNHQ ABOCM ABPLY ABPQP ABPTD ABQLI ABQNK ABTLG ABVGC ABWST ABXSQ ABXVV ACGFO ACGFS ACHIC ACPRK ACUFI ACUKT ACUTO ACYHN ADBBV ADGZP ADHKW ADHZD ADIPN ADNBA ADQBN ADQXQ ADRTK ADULT ADVEK ADYVW ADZXQ AEGPL AEGXH AEJOX AEKSI AEMDU AEMQT AENEX AENZO AEPUE AETBJ AEUPB AEWNT AEXZC AFFNX AFFZL AFIYH AFOFC AFRAH AFXAL AGINJ AGORE AGQPQ AGQXC AGSYK AGUTN AHMBA AHMMS AHXPO AI. AIAGR AJBYB AJEEA AJNCP ALMA_UNASSIGNED_HOLDINGS ALUQC ALXQX APIBT APWMN AQKUS AQVQM ASPBG ATGXG AVWKF AXUDD AZFZN BAWUL BAYMD BCRHZ BEYMZ BHONS BSCLL BTRTY BVRKM C1A C45 CDBKE CS3 CZ4 DAKXR DCCCD DIK DILTD DU5 D~K E3Z EBS EE~ EJD EMOBN ENERS F5P F9B FECEO FEDTE FLUFQ FOEOM FOTVD FQBLK GAUVT GJXCC H5~ HAR HQ3 HTVGU HVGLF HW0 HZ~ IOX IPSME J21 J5H JAAYA JBMMH JENOY JHFFW JKQEH JLS JLXEF JPM JSG JST JXSIZ KAQDR KBUDW KOP KSI KSN L7B MHKGH MJL ML0 N4W N9A NGC NOMLY NOYVH NU- NVLIB O0~ O9- OAUYM OAWHX OCZFY ODMLO ODZKP OJQWA OJZSN OK1 OPAEJ OVD OWPYF P2P P6G PAFKI PB- PEELM PQQKQ Q1. Q5Y QBD RD5 ROX ROZ RUSNO RW1 RXO SA0 SJN TCURE TEORI TJX TMA TR2 VH1 W8F X7H YAYTL YKOAZ YXANX ZGI ~91 ~S- AAYOK AASNB ADACV ADJQC ADRIX AFXEN DOOOF ESX JSODD M49 AAYXX CITATION 1KJ 3O- 70D AAPGJ AAPNW AAWDT ABKDP ABNKS ABSMQ ABZBJ ACFRR ACPQN ACUTJ ACVCV ACZBC ADEYI ADMTO ADOCK AEKPW AFFQV AFSHK AFYAG AGKEF AGKRT AGMDO AHGBF AIJHB AJDVS APJGH AQDSO AVNTJ BZKNY EIHJH H13 IQODW MBLQV OBFPC O~Y Y6R CGR CUY CVF ECM EIF NPM 7QL 7T2 7T7 7U7 7U9 8FD C1K FR3 H94 K9. M7N P64 7X8 |
| ID | FETCH-LOGICAL-c451t-acdc14246c4d51e2e4ae7db468f5d6fc75a61aae750a33e0551d056adc96cdaa3 |
| ISSN | 1058-4838 1537-6591 |
| IngestDate | Fri Jul 11 05:53:31 EDT 2025 Fri Jul 25 05:10:21 EDT 2025 Wed Feb 19 01:53:28 EST 2025 Mon Jul 21 09:14:45 EDT 2025 Thu Apr 24 23:13:14 EDT 2025 Tue Jul 01 04:28:49 EDT 2025 Wed Sep 11 04:50:44 EDT 2024 Thu Jun 19 15:26:31 EDT 2025 Tue Aug 05 16:48:59 EDT 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 11 |
| Keywords | Infection Immune reconstitution syndrome Immunopathology Chemotherapy Treatment Viral disease Definition Antiviral AIDS Predictive factor Immune deficiency |
| Language | English |
| License | CC BY 4.0 |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-c451t-acdc14246c4d51e2e4ae7db468f5d6fc75a61aae750a33e0551d056adc96cdaa3 |
| Notes | istex:081BBB80E0496AA01FD2E154545E39AB2EB4B90A ark:/67375/HXZ-Z8J7JB2Q-C SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 14 ObjectType-Article-1 ObjectType-Feature-2 content type line 23 |
| OpenAccessLink | https://academic.oup.com/cid/article-pdf/42/11/1639/795989/42-11-1639.pdf |
| PMID | 16652323 |
| PQID | 219951816 |
| PQPubID | 48300 |
| PageCount | 8 |
| ParticipantIDs | proquest_miscellaneous_67926245 proquest_journals_219951816 pubmed_primary_16652323 pascalfrancis_primary_17923807 crossref_citationtrail_10_1086_503903 crossref_primary_10_1086_503903 oup_primary_10_1086_503903 jstor_primary_4484803 istex_primary_ark_67375_HXZ_Z8J7JB2Q_C |
| ProviderPackageCode | CITATION AAYXX |
| PublicationCentury | 2000 |
| PublicationDate | 2006-06-01 |
| PublicationDateYYYYMMDD | 2006-06-01 |
| PublicationDate_xml | – month: 06 year: 2006 text: 2006-06-01 day: 01 |
| PublicationDecade | 2000 |
| PublicationPlace | Chicago, IL |
| PublicationPlace_xml | – name: Chicago, IL – name: United States – name: Oxford |
| PublicationTitle | Clinical infectious diseases |
| PublicationTitleAbbrev | Clinical Infectious Diseases |
| PublicationTitleAlternate | Clinical Infectious Diseases |
| PublicationYear | 2006 |
| Publisher | The University of Chicago Press University of Chicago Press Oxford University Press |
| Publisher_xml | – name: The University of Chicago Press – name: University of Chicago Press – name: Oxford University Press |
| References | Emery (1_5726635) 1997; 9 Shelburne (19_18780144) 2005; 19 (2_38267706) 2004; 39 Gebo (12_19476356) 2005; 40 French (14_10086270) 1992; 6 (18_38420488) 2002; 185 French (6_10671550) 2000; 1 Keane (17_11374801) 2001; 126 Hirsch (13_18142363) 2004; 38 (8_38413828) -1; -1 Vendrely (5_19154954) 2005; 109 Domingo (9_11173119) 2001; 110 (10_38344241) 1998; 27 Aldeen (11_6175037) 1998; 12 Shelburne (3_17041133) 2002; 81 Huttner (4_18611921) 2004; 251 Stone (16_17096021) 2002; 3 Lawn (15_18912215) 2005; 5 17143833 - Clin Infect Dis. 2007 Jan 1;44(1):147-8; author reply 148-9 |
| References_xml | – volume: 9 start-page: 568 issn: 0952-7915 issue: 4 year: 1997 ident: 1_5726635 publication-title: Current opinion in immunology doi: 10.1016/S0952-7915(97)80112-4 – volume: 81 start-page: 213 issn: 0025-7974 issue: 3 year: 2002 ident: 3_17041133 publication-title: Medicine doi: 10.1097/00005792-200205000-00005 – volume: 12 start-page: 1719 issn: 0269-9370 issue: 13 year: 1998 ident: 11_6175037 publication-title: AIDS (London, England) – volume: 6 start-page: 1293 issn: 0269-9370 issue: 11 year: 1992 ident: 14_10086270 publication-title: AIDS (London, England) doi: 10.1097/00002030-199211000-00009 – volume: 38 start-page: 1159 issn: 1058-4838 issue: 8 year: 2004 ident: 13_18142363 publication-title: Clinical Infectious Diseases doi: 10.1086/383034 – volume: 3 start-page: 21 issn: 1464-2662 issue: 1 year: 2002 ident: 16_17096021 publication-title: HIV medicine doi: 10.1046/j.1464-2662.2001.00096.x – volume: 27 start-page: 1510 issn: 1058-4838 issue: 6 year: 1998 ident: 10_38344241 publication-title: Clinical Infectious Diseases doi: 10.1086/515019 – volume: 251 start-page: 1522 issn: 0340-5354 issue: 12 year: 2004 ident: 4_18611921 publication-title: Journal of neurology doi: 10.1007/s00415-004-0563-4 – volume: 5 start-page: 361 issn: 1473-3099 issue: 6 year: 2005 ident: 15_18912215 publication-title: The Lancet infectious diseases doi: 10.1016/S1473-3099(05)70140-7 – volume: 19 start-page: 399 issn: 0269-9370 issue: 4 year: 2005 ident: 19_18780144 publication-title: AIDS (London, England) doi: 10.1097/01.aids.0000161769.06158.8a – volume: 185 start-page: 1813 issn: 0022-1899 issue: 12 year: 2002 ident: 18_38420488 publication-title: Journal of Infectious Diseases doi: 10.1086/340636 – volume: 126 start-page: 111 issn: 0009-9104 issue: 1 year: 2001 ident: 17_11374801 publication-title: Clinical and experimental immunology doi: 10.1046/j.1365-2249.2001.01647.x – volume: 1 start-page: 107 issn: 1464-2662 issue: 2 year: 2000 ident: 6_10671550 publication-title: HIV medicine doi: 10.1046/j.1468-1293.2000.00012.x – volume: 109 start-page: 449 issn: 0001-6322 issue: 4 year: 2005 ident: 5_19154954 publication-title: Acta neuropathologica doi: 10.1007/s00401-005-0983-y – volume: 40 start-page: 169 issn: 0894-9255 issue: 2 year: 2005 ident: 12_19476356 publication-title: Journal of acquired immune deficiency syndromes doi: 10.1097/01.qai.0000178408.62675.b0 – volume: -1 start-page: MASTER issn: 0022-1899 year: -1 ident: 8_38413828 publication-title: Journal of Infectious Diseases doi: 10.1093/jnlids/166.5.1153 – volume: 110 start-page: 605 issn: 0002-9343 issue: 8 year: 2001 ident: 9_11173119 publication-title: The American journal of medicine doi: 10.1016/S0002-9343(01)00703-3 – volume: 39 start-page: 1709 issn: 1058-4838 issue: 11 year: 2004 ident: 2_38267706 publication-title: Clinical Infectious Diseases doi: 10.1086/425742 – reference: 17143833 - Clin Infect Dis. 2007 Jan 1;44(1):147-8; author reply 148-9 |
| SSID | ssj0011805 |
| Score | 2.2956865 |
| Snippet | Background. Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for... Background . Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for... Clinical deterioration after initiation of antiretroviral therapy may result from restored immunity. There is no standard clinical definition for immune... |
| SourceID | proquest pubmed pascalfrancis crossref oup jstor istex |
| SourceType | Aggregation Database Index Database Enrichment Source Publisher |
| StartPage | 1639 |
| SubjectTerms | Adult AIDS AIDS-Related Opportunistic Infections - complications Anti-HIV Agents - adverse effects Antibiotics. Antiinfectious agents. Antiparasitic agents Antiretroviral drugs Antiretrovirals Antiviral agents Biological and medical sciences Carts Case-Control Studies CD4 Lymphocyte Count CD8-Positive T-Lymphocytes Diagnostic tests Disease Drug therapy Female Hemoglobins Herpes zoster HIV HIV Infections - complications HIV/AIDS Human immunodeficiency virus Human viral diseases Humans Immune system Immune System Diseases - chemically induced Immune System Diseases - diagnosis Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infections Infectious diseases Lymphocytes Male Medical sciences Opportunistic infections Patients Pharmacology. Drug treatments Retrospective Studies Risk Factors Sensitivity and Specificity Tuberculosis Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| Title | Immune Reconstitution Syndrome in HIV: Validating a Case Definition and Identifying Clinical Predictors in Persons Initiating Antiretroviral Therapy |
| URI | https://api.istex.fr/ark:/67375/HXZ-Z8J7JB2Q-C/fulltext.pdf https://www.jstor.org/stable/4484803 https://www.ncbi.nlm.nih.gov/pubmed/16652323 https://www.proquest.com/docview/219951816 https://www.proquest.com/docview/67926245 |
| Volume | 42 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1fb9MwELeqTUJICPFnsG4w_AC8oKD8sZ2Et1E2tWUbQ2qnai-RkzhSBWRTm0qIz8G34ktxF9tJCisCXqIqca5p75fznX2_O0Keh8KVEXpuEP9wh8lCOmkhcieVXu6HcSGLFLnDp2diOGXjGZ_1ej86WUurKn2dfbuRV_I_WoVzoFdkyf6DZhuhcAI-g37hCBqG41_peITkDmy8kF2ZPf_69TdFCHApYzi6wJj_Arxt5DEgIfHVACYusDPFvJxXNhlZ83U152lgyZLnC9zFqdvxgKjz2jdfgkWB27SsQ7hnoSpclTA8_6ZCgS1-YGXZpK_V0u4JtUn2dXK3YX6N5fxLm46r5hpRpit5d_W_m5rTmC7ToGW8Kn9dzRDd1YwNLMmOgXZ5vQCqbbayRjt0BNddv6xVZ34XvV7HRoMHGt84ebj1XhZ3g9gN2unRpgScfUiOpycnyeRoNlm_aoIpeABs3gKh-LYPMQu203g3et9saXlRnU_b_IBOoyv9lWue0Ta-5F9tkqxlX965lkvQWaF7rmwOimrnaHKP3DVRDT3UEL1Peqp8QG6dmryNh-S7RipdRyq1SKXzkgJS39AWp1RSxCltcUoBp7SDU2qxRVucoiCDU9rilK7jlBqc7pDp8dFkMHRMPxAnY9yrHJnlGRIzRcZy7ilfManCPGUiKniOnDUuhSfhHHdlECgXgoEc_HuZZ7HIcimDR2SrvCrVLqESPNU0TlMWe4yFmS9zlXkK7k4Fk0HE--SF1UWSmWL52LPlc1InbUQi0Trrk2fNuGtdHua3ES9rVTaX5eITJlOGPBnOLpPLaByO3_ofk0Gf7NS6bgYyFrEIBeyB7jdKP1iDRDsM64JGbtgn-xYjibFcy8THugzg2gt4_OYqTCu4VyhLBaYAnhALiTL4Ix5rYLWSheAQhgV7f5S8T263r_cTslUtVuopuO9VelC_Fj8BpaX2pQ |
| linkProvider | Flying Publisher |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Immune+Reconstitution+Syndrome+in+HIV%3A+Validating+a+Case+Definition+and+Identifying+Clinical+Predictors+in+Persons+Initiating+Antiretroviral+Therapy&rft.jtitle=Clinical+infectious+diseases&rft.au=Robertson%2C+Jaime&rft.au=Meier%2C+Matthew&rft.au=Wall%2C+Jennifer&rft.au=Ying%2C+Jun&rft.date=2006-06-01&rft.pub=Oxford+University+Press&rft.issn=1058-4838&rft.eissn=1537-6591&rft.volume=42&rft.issue=11&rft.spage=1639&rft_id=info:doi/10.1086%2F503903&rft.externalDBID=NO_FULL_TEXT&rft.externalDocID=1059107461 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1058-4838&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1058-4838&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1058-4838&client=summon |