PMID- 19687769
OWN - NLM
STAT- MEDLINE
DCOM- 20100330
LR  - 20211020
IS  - 1532-0987 (Electronic)
IS  - 0891-3668 (Print)
IS  - 0891-3668 (Linking)
VI  - 28
IP  - 10
DP  - 2009 Oct
TI  - Immune reconstitution inflammatory syndrome in human immunodeficiency 
      virus-infected children in Peru.
PG  - 900-3
LID - 10.1097/INF.0b013e3181a4b7fa [doi]
AB  - BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) after initiating 
      highly active antiretroviral therapy (HAART) has not been widely studied in 
      children, especially in resource-poor settings. METHODS: Retrospective cohort 
      study of HIV-infected children initiating HAART between 2001 and 2006 at a 
      tertiary pediatric hospital in Lima, Peru. Charts were reviewed for 1 year after 
      HAART initiation. IRIS was defined as a HAART-associated adverse event caused by 
      an infectious or inflammatory condition in patients with documented virologic or 
      immunologic success. RESULTS: Ninety-one children (52% female) received HAART for 
      at least 1 year. Median age at initiation was 5.7 years; 91% were ART naive and 
      73% had CDC stage C disease. The incidence of IRIS was 19.8 events per 100 person 
      years (95% CI: 11.5-28.0). Median time to IRIS was 6.6 weeks after HAART 
      initiation (range: 2-32 weeks). There were 18 IRIS events, 11 unmasking and 7 
      paradoxical. These included associations with Mycobacterium tuberculosis in 4 
      cases, Bacillus Calmette Guerin lymphadenitis in 1 case, varicella zoster virus 
      in 6 cases and herpes simplex labialis in 6 cases. Children who developed IRIS 
      had a higher baseline HIV viral load (P = 0.02) and an indicator of malnutrition 
      (P = 0.007) before HAART initiation. CONCLUSION: IRIS occurred in 20% of 
      HIV-infected children starting HAART in Peru and was associated with more 
      advanced disease and malnutrition. Future research is needed to examine specific 
      risk factors associated with pediatric IRIS to allow prompt identification and 
      treatment of IRIS.
FAU - Wang, Marie E
AU  - Wang ME
AD  - Department of Pediatrics, School of Medicine, Stanford University School of 
      Medicine, Stanford, CA 94305, USA. marie.wang@stanford.edu
FAU - Castillo, Maria E
AU  - Castillo ME
FAU - Montano, Silvia M
AU  - Montano SM
FAU - Zunt, Joseph R
AU  - Zunt JR
LA  - eng
GR  - D43 TW000007/TW/FIC NIH HHS/United States
GR  - P30 AI027757/AI/NIAID NIH HHS/United States
GR  - R01 NS055627/NS/NINDS NIH HHS/United States
GR  - R24 TW007988/TW/FIC NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Pediatr Infect Dis J
JT  - The Pediatric infectious disease journal
JID - 8701858
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Adolescent
MH  - Animals
MH  - Anti-HIV Agents/*adverse effects/*therapeutic use
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Female
MH  - HIV Infections/*drug therapy/immunology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*epidemiology
MH  - Incidence
MH  - Infant
MH  - Male
MH  - Peru/epidemiology
MH  - Retrospective Studies
PMC - PMC3514443
MID - NIHMS380276
EDAT- 2009/08/19 09:00
MHDA- 2010/03/31 06:00
PMCR- 2012/12/04
CRDT- 2009/08/19 09:00
PHST- 2009/08/19 09:00 [entrez]
PHST- 2009/08/19 09:00 [pubmed]
PHST- 2010/03/31 06:00 [medline]
PHST- 2012/12/04 00:00 [pmc-release]
AID - 10.1097/INF.0b013e3181a4b7fa [doi]
PST - ppublish
SO  - Pediatr Infect Dis J. 2009 Oct;28(10):900-3. doi: 10.1097/INF.0b013e3181a4b7fa.