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
Related Articles
- EP ID EP363767
- DOI 10.9790/0853-1702123236
- Views 42
- Downloads 0
Wolf’s isotopic response
We report a case of 36 year old Hindu female who initially presented with the diagnosis of Tinea corporis two months back and was treated with oral and topical antifungals, later on lichenoid plaques were observed at the...
Neurofibromatosis Type 1 Revealed By A Retinal Detachment Caused By A Spontaneous Desinsertion At The Oraserrata
.
Evaluation of Serum Lactate Dehydrogenase Enzyme in Different Grades of Oral Sub Mucous Fibrosis among Patients Attending a Dental College Of Western India.
Oral submucous fibrosis (OSF) is a premalignant disorder associated with the chewing of areca nut (betel nut). OSF itself causes significant morbidity and may also cause mortality, if transformed into oral squamous cell...
Prevalence of Hepatitis B virus infection among voluntary blood donors of a blood bank in a mixed Urban – Rural setting in West Bengal , India
With a 3.7% point prevalence and 40 million HBV carriers, India is considered to be an intermediate endemic zone as per WHO observation. Prevalence of HBV infection among voluntary blood donors indicates the prevalence o...
Prevalence of Gestational Diabetes Mellitus in Nyala City, South Darfur-Sudan
Background: Gestational diabetes mellitus (GDM) is defined as a glucose intolerance during pregnancy where the blood glucose level remains below the diagnostic values of diabetes mellitus. The differences in the prevalen...