01560nas a2200229   4500000000100000008004100001260001300042653004200055653004200097653002500139653001900164653001100183653004800194653001200242100001200254700001600266245005700282300001000339490000800349520095900357022001401316       2008                            d  c2008 Oct10aAIDS-Related Opportunistic Infections10aAntiretroviral Therapy, Highly Active10aCD4 Lymphocyte Count10aHIV Infections10aHumans10aImmune Reconstitution Inflammatory Syndrome10aleprosy1 aDeps PD1 aLockwood DN00aLeprosy occurring as immune reconstitution syndrome.  a966-80 v1023 a<p>Immune reconstitution inflammatory syndrome (IRIS) may occur in HIV-infected patients after starting highly active antiretroviral therapy (HAART). Since 2003, 19 cases were published as IRIS. Leprosy has been reported as an example of an IRIS, and it is important that this syndrome should be recognized in leprosy-endemic areas. The case definition of leprosy as IRIS is based on clinical presentation of leprosy, evidence of immune restoration and timing of onset. Case definition should include the following: (1) leprosy and/or leprosy type 1 reaction presenting within six months of starting HAART; (2) advanced HIV infection; (3) low CD4+ count before start HAART; (4) CD4+ count increasing after HAART has been started. Although pathogenic mechanisms are still unclear, it is likely that leprosy-associated IRIS will be increasingly reported in those countries endemic for both diseases and as access to HAART becomes more widely available.</p>  a1878-3503