title: Recurrent giant molluscum contagiosum immune reconstitution inflammatory syndrome (IRIS) after initiation of antiretroviral therapy in an HIV-infected man.
abstract: We describe an HIV-infected South African man who experienced two distinct episodes of disseminated giant molluscum contagiosum immune reconstitution inflammatory syndrome (IRIS) over a six-year period. The first episode of molluscum contagiosum IRIS occurred with rapid virologic suppression following antiretroviral therapy initiation. The second episode occurred during a rapid increase in CD4 cells following stable viral suppression with second-line antiretroviral therapy. His molluscum contagiosum lesions then completely resolved during a reduction in CD4 count, despite maintaining virologic suppression. Nearly one year after the resolution of his giant molluscum contagiosum IRIS lesions, he maintains an undetectable viral load, but his level of immune deficiency has not improved. In the absence of well-controlled therapeutic trials, molluscum contagiosum IRIS presents important management challenges.
authors: Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
authors: Paul K
authors: PK
authors: Drain
authors: Anisa
authors: A
authors: Mosam
authors: Lilishia
authors: L
authors: Gounder
authors: Bernadett
authors: B
authors: Gosnell
authors: Thandekile
authors: T
authors: Manzini
authors: Mahomed-Yunus S
authors: MY
authors: Moosa
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000821:virology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D015496:CD4-Positive T-Lymphocytes; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000139:chemically induced*; D016867:Immunocompromised Host; D008297:Male; D008976:Molluscum Contagiosum / Q000139:chemically induced / Q000276:immunology* / Q000821:virology; D012008:Recurrence; D013019:South Africa; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects
keywords: HIV/AIDS; IRIS; Molluscum contagiosum; South Africa; antiretroviral therapy; immune reconstitution inflammatory syndrome
references: Indian J Dermatol Venereol Leprol. 2008 May-Jun;74(3):267-8
references: 18583804
references: Korean J Fam Med. 2012 May;33(3):182-5
references: 22787541
references: Br J Dermatol. 2000 Nov;143(5):1026-31
references: 11069514
references: J Eur Acad Dermatol Venereol. 2004 Mar;18(2):230-1
references: 15009318
references: AIDS. 2005 Mar 4;19(4):399-406
references: 15750393
references: AIDS. 1997 Nov 15;11(14):1784-5
references: 9386818
references: Dermatol Online J. 2007 May 01;13(2):6
references: 17498425
references: Int J STD AIDS. 2008 Aug;19(8):503-6
references: 18663032
references: Int J Dermatol. 1999 Sep;38(9):664-72
references: 10517682
references: J Eur Acad Dermatol Venereol. 2000 Nov;14(6):484-8
references: 11444271
references: Pediatr Dermatol. 2010 Nov-Dec;27(6):631-4
references: 21078110
references: J Antimicrob Chemother. 2006 Feb;57(2):167-70
references: 16354748
references: J Am Acad Dermatol. 1992 Oct;27(4):583-8
references: 1357010
references: J Drugs Dermatol. 2003 Dec;2(6):637-9
references: 14711142
references: Dermatol Clin. 2006 Oct;24(4):549-70, vii
references: 17010783
references: Clin Infect Dis. 1997 May;24(5):1023-5
references: 9142826
references: Br J Dermatol. 1998 Apr;138(4):715-7
references: 9640394
references: Br J Ophthalmol. 2003 Nov;87(11):1427-8
references: 14609853
references: AIDS. 2004 Aug 20;18(12):1615-27
references: 15280772