title: Head and neck manifestations of the immune reconstitution syndrome in HIV-infected patients: a cohort study.
abstract: OBJECTIVE
  To describe head and neck manifestations of immune reconstitution inflammatory syndrome (IRIS) in a cohort of HIV-infected patients receiving combined antiretroviral therapy (cART). After initiation of cART, some HIV-infected patients present a paradoxical worsening and clinical deterioration due to pathological inflammatory reactions to infectious or noninfectious antigens, a condition known as IRIS.
  
  
  METHODS
  Prospective study with a follow-up period of 6 to 24 months.
  
  
  METHODS
  Tertiary referral center in Mexico City.
  
  
  METHODS
  Our cohort was integrated by 165 patients who had started cART within the past 2 months prior to study entry. Patients underwent a complete ear, nose, and throat examination (ENT). Laboratory tests (hematology and blood chemistry), cultures from body fluids, and biopsies were performed.
  
  
  RESULTS
  Of the 165 patients studied, 21 (12.7%) presented IRIS in the head and neck region. Kaposi sarcoma was the most common presentation, observed in 7 patients. Tuberculosis-associated IRIS was observed in 6 patients with scrophulas, lymph node enlargement, or retropharyngeal abscess. Other manifestations included herpes simplex I infection and unilateral vocal fold palsy secondary to Mycobacterium avium intracelulare paratracheal abscess and scrophulas, as well as cervical lymph node histoplasmosis and facial palsy.
  
  
  CONCLUSIONS
  To our knowledge, this is the first prospective study describing the different manifestations of IRIS in the head and neck region.
authors.affiliation: Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.
authors.forename: Yuria
authors.initials: Y
authors.lastname: Ablanedo-Terrazas
authors.forename: Claudia
authors.initials: C
authors.lastname: Alvarado-de la Barrera
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Ormsby
authors.forename: Gustavo
authors.initials: G
authors.lastname: Reyes-Terán
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006258:Head and Neck Neoplasms / Q000209:etiology*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000150:complications*; D008297:Male; D010038:Otorhinolaryngologic Diseases / Q000209:etiology*; D011446:Prospective Studies; D012514:Sarcoma, Kaposi / Q000209:etiology*; D014376:Tuberculosis / Q000209:etiology*