Achappa, Basavaprabhu

Unnikrishnan, Deepak Madi

Venugopal, B Anand

English

PubMed

Basavaprabhu Achappa

Deepak Unnikrishnan

B Venugopal

Springer - Publisher Connector

Immune reconstitution inflammatory syndrome (IRIS) in HIV positive patients initiated on antiretroviral therapy (ART)

POSTER PRESENTATION Open Access
Immune reconstitution inflammatory syndrome
(IRIS) in HIV positive patients initiated on
antiretroviral therapy (ART)
Basavaprabhu Achappa*, Deepak Madi Unnikrishnan, B Anand Venugopal
From 17th International Symposium on HIV and Emerging Infectious Diseases (ISHEID)
Marseille, France. 23-25 May 2012
Background
IRIS is defined as ‘occurrence or manifestation of new
opportunistic infections or existing opportunistic infec-
tions within six weeks to six months after initiating antire-
troviral therapy with increase in CD4 count’. The objective
of this study was to determine profile of IRIS in HIV Posi-
tive patients after initiation of ART and correlation of IRIS
with CD4 count.
Methods
This was a case control study done on HIV positive
patients newly initiated on ART at KMC hospital, Manga-
lore. IRIS was diagnosed based on National Aids Control
Organization Guidelines. Cases were defined as those who
developed IRIS after initiation of ART and controls who
did not develop IRIS.
Results
40 cases and 80 controls were studied between May 2008
and May 2010, who were newly initiated on ART during
this period. The cases and controls were compared based
on age, sex, and initial CD4 count, final CD4 count, dura-
tion of ART, ART regimen, opportunistic infections and
their relationship to CD4 count were analyzed. Mean age
of patients who developed IRIS was 36 years. 75% of these
patients were men and remaining 25% were females. Initial
mean CD4 count was 135 and CD4 count at development
of IRIS was 239. The mean duration of ART following
which IRIS developed was 4 months. 65% of patients were
on Lamivudine+Stavudine+Nevirapine regimen, 25% were
on Zidovudine+Lamivudine+Nevirapine, 7.5% were on
Stavudine+Lamivudine+Effavirenz, 2.5% were on Zidovu-
dine+Lamivudine+Effavirenz.
Most common opportunistic infection occurring as
IRIS was pulmonary tuberculosis followed by tubercular
lymphadenitis and pneumocystis jheroveci pneumonia.
Other opportunistic infections seen were oesophageal
candidiasis, isospora duodenitis, CMV Retinitis, crypto-
coccal meningitis, herpes zoster. Tuberculosis accounted
for 52.5% of cases of IRIS.
Conclusion
Most common IRIS was tuberculosis followed by pneu-
mocystis. Tuberculosis as IRIS occurred 2.5 months
after initiation of ART. There was weak correlation
between low CD4 count at ART initiation and occur-
ance of IRIS.
Published: 25 May 2012
doi:10.1186/1742-4690-9-S1-P21
Cite this article as: Achappa et al.: Immune reconstitution inflammatory
syndrome (IRIS) in HIV positive patients initiated on antiretroviral
therapy (ART). Retrovirology 2012 9(Suppl 1):P21.
* Correspondence: bachu1504@gmail.com
Kasturba Medical College Hospital, Mangalore, India
Achappa et al. Retrovirology 2012, 9(Suppl 1):P21
http://www.retrovirology.com/content/9/S1/P21
© 2012 Achappa et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.


Achappa Basavaprabhu

Unnikrishnan Deepak

Venugopal B

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Immune reconstitution inflammatory syndrome (IRIS) in HIV positive patients initiated on antiretroviral therapy (ART)

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