title: [Clinical characteristics of highly active antiretroviral therapy-associated immune reconstruction inflammation in acquired immunodeficiency syndrome].
abstract: OBJECTIVE
  To summarize the morbidity, mortality, clinical manifestations and risk factors for IRIS (immune reconstruction inflammatory syndrome) during HAART (highly active antiretroviral therapy) in China.
  
  
  METHODS
  From October 2007 to September 2009, a prospective cohort of 238 AIDS (acquired immunodeficiency syndrome) patients on HAART from Hunan and Jianxi provinces was recruited for a follow-up of 24 weeks. And 47 and 191 patients were assigned into the IRIS and non-IRIS groups respectively. The data of general information, clinical manifestations and treatment of two groups were collected and compared. Blood samples were collected in both groups at pre-and post-HAART 12 weeks, 24 weeks for HIV viral load and CD4(+) cell count examinations. A statistical analysis was performed.
  
  
  RESULTS
  A total of 47 (19.7%) IRIS cases was analyzed. The median onset of IRIS was 28 (9 - 36) days. And 29 (61.7%) cases of tuberculosis IRIS were found. There was no significant difference in age, gender, route of transmission and antiretroviral regimens between the IRIS and non-IRIS groups. At baseline, Weeks 12 and 24, both groups showed a significant decline of viral load. And there was no significant difference between them. Both groups showed a significant increase of CD4(+) cell count. But there was no significant difference between two groups. However, the baseline CD4(+) cell count was markedly lower in the IRIS group than that in the non-IRIS group. In 85.1% (40/47) of cases, the CD4(+) cell count was < 100 × 10(6)/L in the IRIS group at the baseline of HAART.
  
  
  CONCLUSIONS
  IRIS mostly occurs during 3 months of HAART initiation. The age, gender, route of transmission and antiretroviral treatment regimens of patients on HAART are not risk factors for the development of IRIS. The HIV RNA viral load decreases in both IRIS and non-IRIS groups without any significant difference. The patients with a CD4(+) cell count < 100/µl are more vulnerable to develop IRIS.
authors.affiliation: AIDS Research Laboratory, Second Xiangya Hospital, Central South University, Changsha 410011, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Liu
authors.forename: Yu-Huang
authors.initials: YH
authors.lastname: Zheng
authors.forename: Guo-Qiang
authors.initials: GQ
authors.lastname: Zhou
authors.forename: Hua-Ying
authors.initials: HY
authors.lastname: Zhou
authors.forename: Zi
authors.initials: Z
authors.lastname: Chen
authors.forename: Yan
authors.initials: Y
authors.lastname: He
authors.forename: Xia
authors.initials: X
authors.lastname: Chen
authors.forename: Li-Wen
authors.initials: LW
authors.lastname: Zheng
authors.forename: Lu
authors.initials: L
authors.lastname: Jia
authors.forename: Mei
authors.initials: M
authors.lastname: He
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D005260:Female; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D019562:Viral Load