Immune reconstitution inflammatory syndrome in adult human immunodeficiency virus-infected patients in Thailand.
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.
Aramaki
Maie
M
Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok. Thailand.
Silachamroon
Udomsak
U
Desakorn
Varunee
V
Maek-A-nantawat
Wirach
W
Waiwaruwut
Jirachai
J
Jutiwarakun
Kamonwan
K
Kim
Jerome Hahn
JH
Pitisuttithum
Punnee
P
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
D000305:Adrenal Cortex Hormones