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Case Reports
. 2011:9:38.
doi: 10.4314/pamj.v9i1.71216. Epub 2011 Aug 16.

Disseminated infections due to Immune Reconstitution Inflammatory Syndrome after highly active antiretroviral therapy--report of 3 cases from Nigeria

Dimie Ogoina  1 , Victor Adekunle, Reginald Obiako, Abdulaziz Umar, Michael Akolawole, Joseph Ovosi
Affiliations
Case Reports

Disseminated infections due to Immune Reconstitution Inflammatory Syndrome after highly active antiretroviral therapy--report of 3 cases from Nigeria

Dimie Ogoina et al. Pan Afr Med J. 2011.

Abstract

Immune Reconstitution Inflammatory Syndromes (IRIS) are exaggerated pathological inflammatory reactions occurring after initiation of highly active antiretroviral therapy (HAART) due to exuberant immune responses to occult or apparent opportunistic infections or cancers. In view of paucity of studies from Nigeria, we report 3 cases of IRIS presenting as disseminated infections in HIV-1 infected patients initiating HAART. The first case was a previously healthy female who developed disseminated tuberculosis after 4 weeks of regular HAART. Her HAART regimen was continued and she improved after commencement of anti-tuberculosis drugs, with evidence of progressive increase in CD4 cell count. The second case was a HAART-experienced female who stopped her drugs for 4 months. Two months after recommencement of her previous HAART regimen, she developed features of disseminated herpes zoster infection, despite evidence of decrease in viral load by 95%. HAART was continued and she recovered completely after receiving valaciclovir tablets and antibiotics. The third patient was a female student who was commenced HAART on account of chronic cough and weight loss. Three months after regular HAART, she developed features of disseminated Kaposi's sarcoma involving the skin, oropharynx and lungs, despite evidence of 42% increase in CD4 cell count. Unfortunately, she rapidly deteriorated and died during the course of management. Clinicians should be alert to the possibility of IRIS in HIV-infected patients initiated or re-initiated on HAART. There is need for future prospective studies determining risk factors for IRIS in HIV-infected patients from Nigeria.

Keywords: HAART; HERPES; HIV; IRIS tuberculosis; Immune Reconstitution Inflammatory Syndromes; Nigeria; VZV.

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Figures

Figure 1
Figure 1
Multidermatomal herpes zoster in a female with Disseminated infections due to Immune Reconstitution Inflammatory Syndrome after Highly Active Antiretroviral Therapy
Figure 2
Figure 2
Disseminated Kaposi's sarcoma due to Immune Reconstitution Inflammatory Syndromes (IRIS)-multiple papulonodular dark-coloured generalised skin lesions with oedema especially involving the face
See this image and copyright information in PMC

References

    1. Bonham Shuli, Bohjanen Paul Meya David, David Boulware. Biomarkers of HIV Immune Reconstitution Inflammatory Syndrome. Biomark Med. 2008;2(4):349–361. - PMC - PubMed
    1. Shelburne SA, Visnegarwala F, Darcourt J, Graviss EA, Giordano TP, et al. Incidence and risk factors for immune reconstitution inflammatory syndrome during highly active antiretroviral therapy. AIDS. 2005;19(4):399–406. Mar 4. - PubMed
    1. Breton G, Duval X, Estellat C, Poaletti X, Bonnet D, et al. Determinants of immune reconstitution inflammatory syndrome in HIV type-1 infected patients with tuberculosis after initiation of antiretroviral therapy. Clin Infect Dis. 2004;39(11):1709–12. Dec 1. - PubMed
    1. Park WB, Choe PG, Jo JH, Kim SH, Bang JH, et al. Immune reconstitution inflammatory syndrome in the first year after HAART: influence on long-term clinical outcome. AIDS. 2006;20(18):2390–2. Nov 28. - PubMed
    1. National agency for control of AIDS: National HIV/AIDS Strategic Framework (NSF) 2010-15. 2009 publication. Available at www.naca.gov. Accessed October 1, 2010.

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