Sirisanthana V, Puthanakit T, Oberdorfer A, Akaratham N, Sirisanthana T; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).

Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. TuPeB4404.

Chiang Mai University, Chiang Mai, Thailand

Background: Latent HIV-related infection could be unmasked after initiation of HAART due to restoration of immune response, immune reconstitution inflammatory syndrome;IRIS. To describe the clinical manifestations of IRIS in HIV-infected children. Methods: The prospective observational study of HIV-infected children with CD4 cell< 15%, who started HAART between May 1, 2002 and June 30, 2003. They were followed-up for at least 24 weeks. Results: There were 95 children given HAART, mostly 2 NRTIs plus efavirenz or nevirapine. IRIS occurred in 24 children (29 episodes). The incidence rate was 25.3 per 100 person (95% CI 16.9 to 35.2). Pathogens that caused IRIS included Mycobacterium spp. (12), Cryptococcus neoformans (2) and herpesviruses (15). The mycobacterial infection were presented as pneumonia (5), localized lymphadenopathy (2), disseminated infection (2), subcutaneous nodules (2) and BCGitis (1). The median time between initiation of HAART and the onset of symptoms was 3 weeks (range 1 to 32). Cryptococcal diseases were presented as meningitis at 2 and 7 weeks after HAART. Herpesvirus were presented as herpes labialis (7), herpes zoster (4), chickenpox (3) and herpes simplex virus (HSV) encephalitis (1) at the median time of 5 weeks (range 2 to 21)after HAART. Patients with IRIS had lower initial CD4 cell compare to one without IRIS (60 v.s. 175 cells/mm3, P=0.008). By the time IRIS developed, they showed good res ponse to HAART with mean CD4 change of +168 cells/mm3 and HIV RNA of -2.9 log10 compare to baseline. There were 4 deaths, including a case of HSV encephalitis and 3 cases with mycobacterial infection (from acute respiratory distress syndrome, S. aureus andP. aeruginosa coinfection). Conclusions: The incidence rate of IRIS in advanced stage HIV-infected children after initiation of HAART is high. Clinician should have high index of suspicion in the first few months of HAART.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Antiretroviral Therapy, Highly Active
• Child
• Cryptococcosis
• HIV Infections
• HIV Seropositivity
• Herpes Zoster
• Herpesvirus 3, Human
• Humans
• Incidence
• Mycobacterium Infections
• Prospective Studies

Other ID:

• GWAIDS0038011

UI: 102282227

From Meeting Abstracts