PMID- 37554471
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230810
IS  - 2284-2594 (Electronic)
IS  - 2284-2594 (Linking)
VI  - 10
IP  - 8
DP  - 2023
TI  - Immune Reconstitution Inflammatory Syndrome in Aids Patient After Successful 
      Induction of Virological Suppression with Cabotegravir/Rilpivirine.
PG  - 003981
LID - 10.12890/2023_003981 [doi]
LID - 003981
AB  - Long-acting (LA) cabotegravir/rilpivirine (CAB/RPV) is a complete regimen for the 
      management of human immunodeficiency virus type 1 (HIV-1) infection to replace 
      their oral antiretroviral therapy (ART) when they have been virologically 
      suppressed. We present a case of successful achievement of undetectable HIV RNA 
      viral load levels in an acquired immunodeficiency syndrome (AIDS) patient with 
      long-standing virologic failure within two months of CAB/RPV LA initiation. This 
      was later complicated by immune reconstitution inflammatory syndrome (IRIS) due 
      to Mycobacterium avium-intracellulare (MAI) infection and hepatitis B virus (HBV) 
      reactivation. LEARNING POINTS: This case highlights the efficacy of monthly 
      CAB/RPV LA in rapidly reducing the HIV viral load level in a poorly controlled 
      patient who lacked significant resistance to the two drugs.This is the first case 
      of IRIS reported in the literature while using CAB/RPV LA. IRIS in the setting of 
      occult MAI is well recognised. It would have occurred with good adherence to any 
      regimen which rapidly suppressed the viral load and is unlikely to be due to 
      CAB/RPV. CAB/RPV has no activity against HBV, which may have contributed to its 
      reactivation.The patient had serologic evidence of resolution of prior HBV. 
      However, some patients have covalently closed circular DNA (cccDNA) that may 
      remain long term in hepatocyte nuclei.
CI  - (c) EFIM 2023.
FAU - Al-Handola, Rami
AU  - Al-Handola R
AD  - Department of Internal Medicine, Hurley Medical Center, Michigan State 
      University/College of Human Medicine, Flint, MI, USA.
FAU - Chinnappan, Justine
AU  - Chinnappan J
AD  - Department of Internal Medicine, Hurley Medical Center, Michigan State 
      University/College of Human Medicine, Flint, MI, USA.
FAU - Bakeer, Mohammad
AU  - Bakeer M
AD  - Department of Internal Medicine, Hurley Medical Center, Michigan State 
      University/College of Human Medicine, Flint, MI, USA.
FAU - Osterholzer, Danielle
AU  - Osterholzer D
AD  - Department of Internal Medicine, Hurley Medical Center, Michigan State 
      University/College of Human Medicine, Flint, MI, USA.
AD  - Division of Infectious Diseases, Department of Internal Medicine, Hurley Medical 
      Center, Michigan State University/College of Human Medicine, Flint, MI, USA.
LA  - eng
PT  - Journal Article
DEP - 20230713
PL  - Italy
TA  - Eur J Case Rep Intern Med
JT  - European journal of case reports in internal medicine
JID - 101648453
PMC - PMC10405873
OTO - NOTNLM
OT  - AIDS
OT  - Cabotegravir/rilpivirine
OT  - HIV
OT  - IRIS
OT  - immune reconstitution inflammatory syndrome
COIS- Conflicts of Interests: The Authors declare that there are no competing 
      interests.
EDAT- 2023/08/09 06:43
MHDA- 2023/08/09 06:44
PMCR- 2023/07/13
CRDT- 2023/08/09 04:00
PHST- 2023/06/17 00:00 [received]
PHST- 2023/06/21 00:00 [accepted]
PHST- 2023/08/09 06:44 [medline]
PHST- 2023/08/09 06:43 [pubmed]
PHST- 2023/08/09 04:00 [entrez]
PHST- 2023/07/13 00:00 [pmc-release]
AID - 3981 [pii]
AID - 10.12890/2023_003981 [doi]
PST - epublish
SO  - Eur J Case Rep Intern Med. 2023 Jul 13;10(8):003981. doi: 10.12890/2023_003981. 
      eCollection 2023.