Is acute appendicitis another inflammatory condition associated with highly active antiretroviral therapy (HAART)?
OBJECTIVE
To report the occurrence of acute appendicitis as a possible manifestation of the immune restoration inflammatory syndrome (IRIS) following the commencement of highly active antiretroviral therapy (HAART) in HIV patients.


METHODS
Case-note review of HIV patients on HAART with acute appendicitis.


METHODS
Review of HIV markers, antiretroviral therapy and abdominal ultrasound results of four HIV patients with acute appendicitis and the histopathology reports on the appendix in two of the patients.


RESULTS
From a population of approximately 350 HIV patients on HAART, we found four patients who developed acute appendicitis within 6 months of commencing or changing HAART.


CONCLUSIONS
Acute appendicitis occurring in HIV patients on HAART may represent a variant of IRIS. Further immunohistopathological and epidemiological evaluation will be needed to define this relationship fully.
Aldeen
T
T
Department of Genitourinary Medicine, St George's Hospital, London, UK.
Horgan
M
M
Macallan
D C
DC
Thomas
V
V
Hay
P
P
D000208:Acute Disease; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001064:Appendicitis / Q000139:chemically induced* / Q000276:immunology* / Q000503:physiopathology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D016867:Immunocompromised Host; D007249:Inflammation / Q000503:physiopathology; D008297:Male; D008875:Middle Aged