TY - JOUR KW - Abscess KW - Adult KW - Antiretroviral Therapy, Highly Active KW - Cohort Studies KW - Cutaneous Fistula KW - Dermatitis KW - Disease Susceptibility KW - Female KW - Fistula KW - French Guiana KW - Herpes Simplex KW - Herpes Zoster KW - Histoplasmosis KW - HIV Infections KW - Humans KW - Immunocompromised Host KW - Immunologic Memory KW - Leishmaniasis, Cutaneous KW - leprosy KW - Lymphatic Diseases KW - Male KW - Middle Aged KW - Recurrence KW - Retrospective Studies KW - Skin Diseases, Infectious KW - Tuberculosis, Lymph Node AU - Sarazin E AU - Nacher M AU - Toure Y AU - Clyti E AU - El Guedj M AU - Aznar C AU - Vaz T AU - Sainte-Marie D AU - Sobesky M AU - Carme B AU - Couppié P AB -

Immune reconstitution syndrome (IRIS) is an unusual inflammatory reaction to an opportunistic infection in an HIV-positive patient. This syndrome occurs when immunity is restored in the first months of an effective highly active antiretroviral treatment (HAART). First, we described all patients with a cutaneous form of IRIS. Then, between 1992 and 2004 we conducted a retrospective cohort study comparing Herpes Zoster and Herpes Simplex infections among untreated patients, patients treated by HAART for < or = six months, and patients treated for > six months. We observed three cases of atypical leprosy and three original observations: two of these were fistulisation of lymph node histoplasmosis and tuberculosis, the third one reports the recurrence of a treated cutaneous leishmaniasis. Multivariate analysis showed that, after controlling for age, sex and CD4 counts, patients receiving HAART for < or = six months were more likely to develop Herpes Zoster or herpes simplex infections (p < 0.005). Herpes Simplex and Herpes Zoster infections are the two most frequent dermatological manifestations in our tropical setting. Although mycobacterial infections are more rarely observed than in visceral IRIS, the increased incidence of leprosy may be quite significant when the availability of HAART spreads to developing countries.

BT - Bulletin de la Societe de pathologie exotique (1990) C1 - http://www.ncbi.nlm.nih.gov/pubmed/16267958?dopt=Abstract DA - 2005 Sep IS - 3 J2 - Bull Soc Pathol Exot LA - fre N2 -

Immune reconstitution syndrome (IRIS) is an unusual inflammatory reaction to an opportunistic infection in an HIV-positive patient. This syndrome occurs when immunity is restored in the first months of an effective highly active antiretroviral treatment (HAART). First, we described all patients with a cutaneous form of IRIS. Then, between 1992 and 2004 we conducted a retrospective cohort study comparing Herpes Zoster and Herpes Simplex infections among untreated patients, patients treated by HAART for < or = six months, and patients treated for > six months. We observed three cases of atypical leprosy and three original observations: two of these were fistulisation of lymph node histoplasmosis and tuberculosis, the third one reports the recurrence of a treated cutaneous leishmaniasis. Multivariate analysis showed that, after controlling for age, sex and CD4 counts, patients receiving HAART for < or = six months were more likely to develop Herpes Zoster or herpes simplex infections (p < 0.005). Herpes Simplex and Herpes Zoster infections are the two most frequent dermatological manifestations in our tropical setting. Although mycobacterial infections are more rarely observed than in visceral IRIS, the increased incidence of leprosy may be quite significant when the availability of HAART spreads to developing countries.

PY - 2005 SP - 187 EP - 92 T2 - Bulletin de la Societe de pathologie exotique (1990) TI - [Dermatologic manifestations associated with immune reconstitution syndrome in HIV+ patients starting HAART: a retrospective study in French Guiana]. VL - 98 SN - 0037-9085 ER -