01930nas a2200361   4500000000100000008004100001260001300042653004200055653002000097653002400117653002800141653001100169653001900180653001100199653002300210653001200233653000900245653001600254100001500270700001100285700001500296700001400311700001600325700001300341700001900354700001300373245008100386300001300467490000800480050001600488520105000504022001401554       2004                            d  c2004 Aug10aAIDS-Related Opportunistic Infections10aAnti-HIV Agents10aAutoimmune Diseases10aDiagnosis, Differential10aFemale10aHIV Infections10aHumans10aLeprostatic Agents10aleprosy10aMale10aMiddle Aged1 aCouppié P1 aAbel S1 aVoinchet H1 aRoussel M1 aHélénon R1 aHuerre M1 aSainte-Marie D1 aCabié A00aImmune reconstitution inflammatory syndrome associated with HIV and leprosy.  a997-10000 v140  aCOUPPIE20043 a<p><b>BACKGROUND: </b>Immune reconstitution inflammatory syndrome (IRIS) is an unusual inflammatory reaction to an opportunistic infection that occurs in human immunodeficiency virus (HIV)-positive patients with profound immunosuppression during the reconstitution of the immune system in the initial months of highly active antiretroviral treatment.</p><p><b>OBSERVATIONS: </b>We describe 3 cases of leprosy occurring in patients treated with a combination of 3 antiretroviral drugs who fulfilled the criteria for IRIS. A reactional state occurred in all 3 cases. Two of the 3 patients presented an unusual ulcerous progression of the lesions not generally observed in cases of leprosy. The outcome was favorable in all 3 cases. The frequency of IRIS associated with leprosy in French Guiana and Martinique is estimated at 3 cases per 1000 HIV-positive patients receiving highly active antiretroviral treatment.</p><p><b>CONCLUSION: </b>Leprosy should be recognized as an IRIS-associated infection with possibility of atypical presentation.</p>  a0003-987X