Leishmaniasis as a Manifestation of Immune Reconstitution Inflammatory Syndrome (IRIS) in HIV-Infected Patients: A Literature Review. (September 2015)

• Record Type: Journal Article
• Authors: Badaró, Roberto; Gonçalves, Larissa O.; Gois, Luana L.; Maia, Zuinara Pereira Gusmão; Benson, Constance; Grassi, Maria Fernanda Rios
• Is Part Of: Journal of the International Association of Providers of AIDS Care. Volume 14:Number 5(2015:Sep./Oct.)
• Page Start: 402
• Page End: 407
• Publication Date: 2015-09
• Subjects: HIV/AIDS -- immune reconstitution inflammatory syndrome -- IRIS -- leishmaniasis -- co-infection HIV/Leishmania; AIDS (Disease) -- Periodicals; 616.9792
• DOI: 10.1177/2325957414555225
• Languages: English
• ISSNs: 2325-9574

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/mm 3, 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.