title: Immune reconstitution inflammatory syndrome in adult human immunodeficiency virus-infected patients in Thailand.
abstract: Immune reconstitution inflammatory syndrome (IRIS) is an important adverse event among human immunodeficiency virus (HIV)-infected patients taking highly active antiretroviral therapy (HAART). The epidemiology of IRIS in Thailand has not been well examined, especially among adult HIV-infected patients. In the present study, we reviewed the medical records of 174 HIV-infected, antiretroviral therapy-naive patients older than 15 years (the median CD4 count at commencement of HAART was 37 cells/mm3) and compared characteristics of patients with and without IRIS. During a 12-month follow-up period after commencement of HAART, 11 cases (6.3%) of IRIS were identified (4.2/100 patient-years HAART). The cases included nine cases with mycobacterial infection, one with cytomegalovirus retinitis and one with cryptococcal meningitis. The patients with IRIS were significantly younger than those without IRIS (29 vs 36 on medians, p = 0.022). The median interval between commencement of HAART and the onset of IRIS was 22 days. Although all patients with IRIS improved with or without corticosteroids, they were more frequently hospitalized during a 12-month follow-up period while taking HAART (1 vs 0 on medians, p < 0.001). The incidence of IRIS in advanced adult HIV-infected patients in Thailand was lower than that reported from Europe and the United States, which may be attributable to deferment of HAART after diagnosing opportunistic infections.
authors.affiliation: Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok. Thailand.
authors.forename: Maie
authors.initials: M
authors.lastname: Aramaki
authors.forename: Udomsak
authors.initials: U
authors.lastname: Silachamroon
authors.forename: Varunee
authors.initials: V
authors.lastname: Desakorn
authors.forename: Wirach
authors.initials: W
authors.lastname: Maek-A-nantawat
authors.forename: Jirachai
authors.initials: J
authors.lastname: Waiwaruwut
authors.forename: Kamonwan
authors.initials: K
authors.lastname: Jutiwarakun
authors.forename: Jerome Hahn
authors.initials: JH
authors.lastname: Kim
authors.forename: Punnee
authors.initials: P
authors.lastname: Pitisuttithum
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000209:etiology; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D017677:Age Distribution; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications* / Q000188:drug therapy; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013785:Thailand; D019562:Viral Load; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones