Title: Incidence of Immune Reconstitution Inflammatory Syndrome in HIV Infected Children in Peru
1Incidence of Immune Reconstitution Inflammatory
Syndrome in HIV Infected Children in Peru
- M.E. Wang1, M.E. Castillo2, J.R. Zunt3
1Stanford University School of Medicine,
Stanford, USA 2Instituto Nacional de Salud del
Niño, Infectious Diseases Service, Lima, Peru,
3University of Washington, Departments of
Neurology, Global Health and Medicine (Infectious
Diseases), Seattle, USA Research supported by
the NIH/Fogarty International Clinical Research
Scholars Program
2Introduction
- IRIS Clinical deterioration due to an infectious
or inflammatory response shortly after the start
of HAART therapy, with concurrent immune recovery - 10-32 incidence in adults, 19 in children
Methods
- Retrospective
- Population All children starting HAART at the
Instituto Nacional de Salud del Niño, Peru,
2002-06
- IRIS Definition Occurrence of a condition
previously associated with IRIS within a year of
starting HAART, in a patient with virologic or
immunologic success
3Results
- 91 patients evaluated
- 19.8 (18/91) of patients developed IRIS
- 33 of cases (6/18) from Mycobacterium spp.
- M. tuberculosis 5 cases
- BCG adenitis 1 case
- 33 of cases (6/18) from varicella zoster virus
- 33 of cases (6/18) from herpes simplex labialis
- All cases resolved, no IRIS related mortality
- Median time to onset 6.6 weeks (Range 2-34)
- 33 had a previous diagnosis with the IRIS
infection - 39 required hospitalization for IRIS
4Results
- No significant differences between the IRIS and
non-IRIS groups with regards to age, sex,
treatment regimen, CDC disease stage, pre-HAART
CD4 count - Significant differences
Conclusions
- IRIS is a common occurrence in HIV-infected
children starting HAART in Peru - Incidence and range of causes was similar to
those found in other studies - Future studies should examine risk factors so
patients more susceptible can be identified and
treated promptly