Abstract
Adverse effects of antiretroviral therapy or another disease?
Highlights
The immune reconstitution inflammatory syndrome (IRIS) is a paradoxical inflammatory response that can occur in patients infected with human immunodeficiency virus (HIV) who receive antiretroviral therapy (ART) in the first weeks after starting therapy, due to the restoration of immunity to specific infectious or non-infectious antigens [1]
It is often difficult to distinguish between symptoms related to the HIV infection and those caused by ART [1]
Among the biological investigations Elisa-HIV 1,2 test is performed, with a positive result and the patient is transferred to the HIV/AIDS Department – “Victor Babes” Hospital for Infectious Diseases and Pneumology Craiova
Summary
The immune reconstitution inflammatory syndrome (IRIS) is a paradoxical inflammatory response that can occur in patients infected with human immunodeficiency virus (HIV) who receive antiretroviral therapy (ART) in the first weeks after starting therapy, due to the restoration of immunity to specific infectious or non-infectious antigens [1]. IRIS comes in two forms: IRIS “unmasking” refers to the appearance of an underlying infection, previously undiagnosed, shortly after the start of antiretroviral therapy (ART); IRIS “paradoxically” refers to the aggravation of a previously treated infection after the onset of ART. This syndrome has three rules: anything is possible, nothing is as it was in the era before ART, IRIS does not mean that ART has failed. The benefits of ART therapy are proved by immunological monitoring (by rapid increase in CD4) and by virological reactions (decrease in HIV-1 viral plasma load) Despite such benefits, initiation of therapy is followed by secondary inflammatory response with clinical deterioration (general nonspecific symptoms such as fever) and impairment of certain organ function [3]. As exact estimates of incidence are not yet available and the spectrum of symptoms and etiology is variable, but increasing, in patients receiving ART, IRIS still remains a problem of diagnosis and treatment [4]
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