16th International AIDS Conference


Toronto, Canada - August 13 - 18, 2006

STUDY OF IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME (IRIS) IN RESOURCE LIMITED SETTINGS

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. MoAb0305

Bhrushundi M., Mishra P.
Lata Mangeshkar Hopital, Nagpur, India

BACKGROUND: With increase access to ART there is going to be rise in cases of IRIS.

METHODS: The study was carried out at private set up in Central India. ART was initiated as per WHO guidelines after treating suspected and diagnosed opportunistic infections. During the follow up, cases that showed signs of deterioration after starting ART were carefully examined and investigated. Those cases that had significant increase in CD 4+T-helper cells were included in the study. All the cases were counseled specifically for symptomatology of IRIS.

RESULTS: Of 720 who was started on ART 68(9.44%) had IRIS. Mean CD+T-helper cell count in these cases was 45/cmm as against 125cell/cmm in those who did not develop IRIS. Mean CD4+ increase was 50/cmm. Of 68 IRIS cases 42(61.76%) had TB IRIS, 10(14.7%) cases had PCP, 8(11.76%) had Cryptococcal meningitis, 4(5.88%) cases had CMV retinitis, 2(2.94%) had Toxoplasma encephalitis and each case (1.47%) of Hepatitis C and Progressive multifocal leukoencephalopathy. Of 42 cases of TB IRIS, 36 had extra-pulmonary TB. One each case of PCP and Cryptococcal meningitis died during the study.

CONCLUSIONS: After initiating ART in individuals with low CD4+T-helper cells, meticulous follow up and patients awareness can detect the IRIS early. TB IRIS tops too followed by PCP. IRIS increases cost of the treatment especially with CMV, Hepatitis C and Cryptococcal meningitis IRIS. IRIS can have fetal outcome also.

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2006-08-13
MoAb0305

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