Immune Reconstitution Inflammatory Syndrome in HIV Patients Initiated On Highly Active Antiretroviral Therapy
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 17, Issue 2
Abstract
Background: Immune reconstitution inflammatory syndrome (IRIS) in Human Immunodeficiency virus (HIV) patients receiving highly active antiretroviral therapy (HAART) is on a rise in third world countries. The diagnosis is a dilemma for the treating physician. Here we provide information on the clinical manifestations, outcomes of IRIS and the correlation of time of IRIS with the CD4 count. Methods: A Prospective descriptive study conducted over a period of two years in a tertiary care teaching institute in south India. A total of 516 patients diagnosed with HIV were started on Lamivudine and Nevirapine based regimen of which 40 who developed IRIS were studied. Inferential statistical analysis was applied. Results: The mean time for development of IRIS was 75 days into HAART. Most were in the age group 31-40yr (42.5%) with male preponderance (67.5%). Fever was the most common complaint (67.5%) followed by headache. Haemoglobin at the time of diagnosis of IRIS was usually low.CD4 count at the start of therapy averaged at 125/mm3 and mean increase in CD4 count was 50.3% .Tuberculosis (pulmonary TB) was the most common infection leading to IRIS. Majority (93.75%) of the cases had mild to moderate outcomes. Conclusion: IRIS been firmly established as a significant problem in both high and low income countries. Clinicians when initiating ART should have a high degree of clinical suspicion and individualize therapy according to known treatment options for the specific infectious agent. Early recognition and treatment has drastic impact on the outcome of IRIS.
Authors and Affiliations
Dr. Vivek Gopinathan, Dr. Siju V Abraham, Dr. Rahul VC Tiwari
Keywords
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- EP ID EP363767
- DOI 10.9790/0853-1702123236
- Views 54
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