Explain Psychoneuroimmunology of immune reconstitution inflammatory syndrome

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Over one-third of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients under antiretroviral (ARV) treatment develop the immune reconstitution inflammatory syndrome (IRIS). The variables that predispose for IRIS are not fully understood. Among the most striking features of IRIS, are aggressive resurgence HIV/AIDS-related cancers and oral manifestations of HIV/AIDS that include oral Kaposi, hairy leukoplakia, and oral ulcers such as recurrent aphthous stomatitis (RAS). Since the etiology for RAS may include anxiety, the hypothesis is projected that anxiety and related psychoemotional states might be significant predictors of IRIS by altering the psychoneuroimmune regulation. We suggest that temporomandibular joint disorders (TMDs) may also be uncovered in IRIS. A well-articulated translational health care program is timely and critical for the relevance of oral manifestations of IRIS such as RAS and TMD.

Over one-third of the patients seropositive for HIV, with signs of AIDS and under treatment with ARV interventions develop IRIS.  It is not clear what variables determine whether a patient with HIV/AIDS will develop ARV-related IRIS but the BEB so far indicates that HIV/AIDS patients with low cluster of differentiation 4 (CD4) cell count and HIV/AIDS patients whose CD4 count recovery show a sharp slope, have a particularly fast "immune reconstitution" and are at greater risk of developing IRIS. Still, even after taking into account these two significant predictors, the medical establishment is currently at a loss to explain the variables that may determine rather important odds for ARV-related IRIS.

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