PMID- 19258527
OWN - NLM
STAT- MEDLINE
DCOM- 20090603
LR  - 20101216
IS  - 1545-1097 (Print)
IS  - 1545-1097 (Linking)
VI  - 8
IP  - 2
DP  - 2009 Mar-Apr
TI  - Immune reconstitution inflammatory syndrome in a resource-poor setting.
PG  - 122-7
LID - 10.1177/1545109709332469 [doi]
AB  - The immune reconstitution inflammatory syndrome (IRIS) associated with highly 
      active antiretroviral therapy (HAART) was studied in rural Ethiopian HIV-infected 
      patients. Review of 1002 charts in an outpatient clinic was conducted. The median 
      CD4 count was 89 cells/mm(3). Ninety-eight patients were hospitalized after 
      initiation of HAART, of whom 74 were hospitalized for manifestations of IRIS (ie, 
      7% of patients on HAART). Of the 74 patients hospitalized with IRIS, 27 patients 
      had tuberculosis; 12 patients, cryptococcal meningitis; 7 patients, 
      toxoplasmosis; 6 patients, pneumonia and/or effusion; and 5 patients, 
      Pneumocystis jiroveci pneumonia (PCP). Ten adult patients were admitted with 
      gastroenteritis, heretofore not recognized as a manifestation of IRIS. Eighty-one 
      percent of IRIS patients were hospitalized within 3 months of beginning HAART and 
      99% by 6 months. Of those hospitalized with IRIS, 4 patients (5%) died while in 
      the hospital (3 with cryptococcal meningitis). Thirty-seven or 50% of those 
      hospitalized with IRIS were lost to medical follow up, thus the mortality rate is 
      likely a gross underestimate of the severity of IRIS. In resource-poor settings 
      where the primary goal is to initiate HAART, IRIS may go unrecognized and have 
      fatal consequences.
FAU - Klotz, Stephen A
AU  - Klotz SA
AD  - Section of Infectious Diseases, School of Health Sciences, University of Arizona, 
      Tucson, Arizona 85724, USA. sklotz@u.arizona.edu
FAU - Aziz Mohammed, Abdul
AU  - Aziz Mohammed A
FAU - Girmai Woldemichael, Mulugeta
AU  - Girmai Woldemichael M
FAU - Worku Mitku, Mongistu
AU  - Worku Mitku M
FAU - Handrich, Mitchell
AU  - Handrich M
LA  - eng
PT  - Journal Article
DEP - 20090303
PL  - United States
TA  - J Int Assoc Physicians AIDS Care (Chic)
JT  - Journal of the International Association of Physicians in AIDS Care (Chicago, 
      Ill. : 2002)
JID - 101185740
SB  - IM
MH  - *AIDS-Related Opportunistic Infections/etiology/mortality
MH  - Adult
MH  - *Antiretroviral Therapy, Highly Active
MH  - CD4 Lymphocyte Count
MH  - Ethiopia/epidemiology
MH  - Female
MH  - *HIV Infections/complications/drug therapy/immunology/virology
MH  - HIV-1
MH  - *Hospitalization/statistics & numerical data
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*etiology/mortality
MH  - Male
MH  - Poverty
MH  - Risk Factors
MH  - Severity of Illness Index
EDAT- 2009/03/05 09:00
MHDA- 2009/06/06 09:00
CRDT- 2009/03/05 09:00
PHST- 2009/03/05 09:00 [entrez]
PHST- 2009/03/05 09:00 [pubmed]
PHST- 2009/06/06 09:00 [medline]
AID - 1545109709332469 [pii]
AID - 10.1177/1545109709332469 [doi]
PST - ppublish
SO  - J Int Assoc Physicians AIDS Care (Chic). 2009 Mar-Apr;8(2):122-7. doi: 
      10.1177/1545109709332469. Epub 2009 Mar 3.