Tegumentary leishmaniasis as a manifestation of immune reconstitution inflammatory syndrome in 2 patients with AIDS.
Immune reconstitution inflammatory syndromes (IRISs) have been reported in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS) since the introduction of highly active antiretroviral therapy (HAART). This syndrome is characterized by clinical manifestations of opportunistic infections when signs of immune reconstitution are observed during therapy. We report on leishmaniasis, suggestive of HAART-induced IRIS, in 2 patients with AIDS. After beginning HAART, 1 patient presented with disseminated, tegumentary lesions, whereas the other patient's preexisting lesions worsened and became more extensive; however, at the same time, their CD4(+) T cell counts were recovering and their virus loads were decreasing significantly. The lesions healed with anti-Leishmania therapy.
Posada-Vergara
Maria P
MP
Laboratorio de Soroepidemiologia e Imunobiologia, Instituto de Medicina Tropical de Sao Paulo, Departamento de Doencas Infecciosas e Parasitarias and Instituto de Infectologia Emilio Ribas, Brazil.
Lindoso
Jose A L
JA
Tolezano
Jose Eduardo
JE
Pereira-Chioccola
Vera Lucia
VL
Silva
Marcos Vinicius
MV
Goto
Hiro
H
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000473:pathology*; D000818:Animals; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D007891:Leishmania / Q000302:isolation & purification*; D016773:Leishmaniasis, Cutaneous / Q000276:immunology / Q000469:parasitology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013577:Syndrome