title: Immune reconstitution inflammatory syndrome associated with disseminated mycobacterial infection in patients with AIDS.
abstract: Restoration of the immune system after highly active antiretroviral therapy (HAART) resulting from a quantitative and qualitative process of cell immune activity recovery may evolve with adverse clinical phenomena, known as the immune reconstitution inflammatory syndrome (IRIS). It can occur in association with several opportunist infections, although most reported cases have been related to mycobacterial infection caused by Mycobacterium tuberculosis and Mycobacterium avium. We describe three clinical cases of mycobacterial infection with different presentation patterns of IRIS after HAART. In each of these patients, immune reconstitution led to clinical manifestation of a latent infection, or clinical worsening of preexisting lesions, or manifestation of new lesions in the central nervous system. Clinical aspects of IRIS are presented in the paper and clinical management options for this event are carefully discussed.
authors: Department of Infectious and Parasitic Diseases, School of Medicine, University of Sao Paulo, SP, Brazil. ffbt@pop.com.br
authors: Felipe Francisco
authors: FF
authors: Tuon
authors: Grace Carvajal
authors: GC
authors: Mulatti
authors: Walkyria Pereira
authors: WP
authors: Pinto
authors: Francisco Oscar
authors: FO
authors: de Siqueira Franca
authors: Ronaldo Cesar
authors: RC
authors: Gryschek
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000150:complications*; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications*; D020306:Tuberculosis, Central Nervous System / Q000150:complications / Q000175:diagnosis / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000382:microbiology