Roberto Badaró1, Larissa O Gonçalves2, Luana L Gois3, Zuinara Pereira Gusmão Maia2, Constance Benson4, Maria Fernanda Rios Grassi3. 1. Universidade Federal da Bahia, Complexo Hospitalar Prof Edgard Santos, Unidade docente de Infectologia, Salvador, BA, Brazil rbadaro884@gmail.com. 2. Universidade Federal da Bahia, Complexo Hospitalar Prof Edgard Santos, Unidade docente de Infectologia, Salvador, BA, Brazil. 3. Fundação Oswaldo Cruz, Centro de Pesquisa Gonçalo Moniz, Laboratório Avançado de Saúde Pública, Salvador, BA, Brazil Escola Bahiana de Medicina e Saúde Pública, Faculdade de Medicina, Salvador, BA, Brazil. 4. University of California San Diego, Division of Infectious Diseases, La Jolla, CA, USA.
Abstract
INTRODUCTION: After the onset of highly active antiretroviral therapy (HAART), some HIV-infected patients present a severe inflammation in response to a latent or a previously treated opportunistic pathogen termed immune reconstitution inflammatory syndrome (IRIS). Few reports of tegumentary and visceral leishmaniasis have been described in association with IRIS. METHODS: A systematic literature review of IRIS in association with leishmaniasis identified 34 reported cases. RESULTS AND DISCUSSION: The majority of these occurred in males 4 months following the onset of HAART. The mean CD4 count before HAART was 94 ± 77 cells/mm³ increasing to 5 times the initial value between the onset of HAART and IRIS presentation. Visceral leishmaniasis and post-kala-azar dermal leishmaniasis were the most commonly reported clinical manifestations, followed by tegumentary leishmaniasis and uveitis. CONCLUSIONS: Commonly found characteristics included cutaneous involvement, regardless of Leishmania species; appearance of lesions unrelated to time of probable Leishmania infection; rapid recovery of CD4 count following HAART; and rapid progression.
INTRODUCTION: After the onset of highly active antiretroviral therapy (HAART), some HIV-infectedpatients present a severe inflammation in response to a latent or a previously treated opportunistic pathogen termed immune reconstitution inflammatory syndrome (IRIS). Few reports of tegumentary and visceral leishmaniasis have been described in association with IRIS. METHODS: A systematic literature review of IRIS in association with leishmaniasis identified 34 reported cases. RESULTS AND DISCUSSION: The majority of these occurred in males 4 months following the onset of HAART. The mean CD4 count before HAART was 94 ± 77 cells/mm³ increasing to 5 times the initial value between the onset of HAART and IRIS presentation. Visceral leishmaniasis and post-kala-azar dermal leishmaniasis were the most commonly reported clinical manifestations, followed by tegumentary leishmaniasis and uveitis. CONCLUSIONS: Commonly found characteristics included cutaneous involvement, regardless of Leishmania species; appearance of lesions unrelated to time of probable Leishmania infection; rapid recovery of CD4 count following HAART; and rapid progression.
Authors: S Antinori; E Longhi; G Bestetti; R Piolini; V Acquaviva; A Foschi; S Trovati; C Parravicini; M Corbellino; L Meroni Journal: Br J Dermatol Date: 2007-09-13 Impact factor: 9.302
Authors: Anne Bourgarit; Guislaine Carcelain; Valerie Martinez; Caroline Lascoux; Veronique Delcey; Brigitte Gicquel; Eric Vicaut; Philippe H Lagrange; Daniel Sereni; Brigitte Autran Journal: AIDS Date: 2006-01-09 Impact factor: 4.177
Authors: Graeme Meintjes; Katalin Andrea Wilkinson; Molebogeng Xheeda Rangaka; Keira Skolimowska; Kerryn van Veen; Musaed Abrahams; Ronnett Seldon; Dominique J Pepper; Kevin Rebe; Priscilla Mouton; Gilles van Cutsem; Mark Patrick Nicol; Gary Maartens; Robert John Wilkinson Journal: Am J Respir Crit Care Med Date: 2008-08-28 Impact factor: 21.405
Authors: Benjamin T Schleenvoigt; Ralf Ignatius; Michael Baier; Thomas Schneider; Marko Weber; Stefan Hagel; Christina Forstner; Mathias W Pletz Journal: Infection Date: 2015-06-30 Impact factor: 3.553
Authors: Arthur Dujardin; Arnaud de La Blanchardière; Julia Dina; Karl Stefic; Christophe Ravel; Julie Bonhomme; Renaud Verdon; Anna Lucie Fournier Journal: Front Immunol Date: 2021-04-21 Impact factor: 7.561
Authors: Wim Adriaensen; Thomas P C Dorlo; Guido Vanham; Luc Kestens; Paul M Kaye; Johan van Griensven Journal: Front Immunol Date: 2018-01-12 Impact factor: 7.561