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  9th European AIDS Conference (EACS)
Warsaw, Poland
Oct 25-29, 2003
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  Reported by Jules Levin
The aim of this study presented at the European AIDS Conference (October 2003) is to determine the incidence and predictors of IRIS, immune reconstitution inflammatory syndrome, among an ethnically diverse cohort of antiretroviral- naïve HIV infected patients initiating HAART.
This is a case control study of HIV-infected patients who commenced HAART between 01/01/2000 and 30/08/2002 at Kings College Hospital, London, UK. Case notes were reviewed to identify any primary or recurrent clinical events consistent with IRIS within 6 months of starting HAART, for data at baseline and either at the time of IRIS or at 16 weeks after HAART in the controls.
Of 200 eligible patients, 51% were male, 59% black African, 29.5% were white, and 10.5% black Caribbean. The median CD4 count and viral load at initiation of HAART was 172 cells and 36,878 copies/ml.
42 (21%) had IRIS events at a median of 12 weeks (range 4 - 24 weeks) following HAART: 24 (57%) were due to genital HSV (mainly more severe or frequent recurrences), 10 (24%) to HPV, 4 (9.5%) to Molluscum and 4 (9.5%) to VZV infection. 3 had TB, 2 hepatitis B and 1 KS.
There were no independent factors associated with the development of IRIS. Cases and controls were similar in gender, age, race, risk group, baseline and 16 week change in CD4 count and viral load, and type of HAART.
The authors concluded that approximately one third of patients experience IRIS events within 16 weeks of initiating HAART, and this most commonly manifests as more severe or recurrent genital herpes or other dermatological infections. There are no well defined predisposing factors for the development of IRIS.
Reference: 9TH EUROPEAN AIDS CONFERENCE (EACS), 1st EACS RESISTANCE & PHARMACOLOGY WORKSHOP, October 25 - 29, 2003 Warsaw, Poland. Oral Abstract F4/4 - EPIDEMIOLOGY OF IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME (IRIS) IN AN ETHNICALLY DIVERSE HIV INFECTED COHORT. Thevarajan I., Chiu C., Murad S., Easterbrook P. Kings College Hospital, Denmark Hill, United Kingdom