Fernández-Martínez RF, Arenas R

Idioma: Español
Referencias bibliográficas: 26
Paginas: 113-119
Archivo PDF: 157.75 Kb.

RESUMEN

El síndrome inflamatorio de reconstitución inmune se presenta en pacientes con infección por VIH/SIDA, semanas o meses después del inicio del tratamiento antirretroviral. Consiste en síntomas y signos que pueden ser graves cuando fueron tratados previamente por una infección oportunista aparentemente curada, al hacerse evidente una infección oportunista subclínica o cuando una infección oportunista bajo tratamiento se agrava. Se presenta en el 10 al 25% de todos los pacientes de cualquier edad que inician la terapia antirretroviral y hasta en el 45% de quienes tienen una infección oportunista previa. Ocurre con más frecuencia con conteos de linfocitos CD4+ menores de 50 cels/mm³, y como resultado de un reestablecimiento de la respuesta inmune.
La inmunopatogenia precisa es desconocida, pero se considera que es desencadenada por antígenos y microorganismos infectantes. La duración del síndrome es de semanas a meses, la mayoría son leves y se resuelven espontáneamente. En el 50% hay manifestaciones en piel. El tratamiento consiste en continuar con la terapia antirretroviral, iniciar, continuar o ajustar el tratamiento de la infección oportunista, y el uso de corticosteroides o antiinflamatorios no esteroideos cuando sea necesario.

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