Immune Reconstitution Inflammatory Syndrome among Adolescents: A Report of Cases in a Resource-Limited Setting (Uganda)

Abstract

The immune reconstitution inflammatory syndrome (IRIS) is a frequent early complication of antiretroviral therapy (ART), particularly in patients who commence ART with low CD4 counts and established opportunistic infections. IRIS in HIV-infected patients results from a pathological inflammatory response to pre-existing infective, host or other antigens, alive or dead, causing clinical deterioration after initiating ART.1 The most common forms of IRIS occur in association with mycobacterial and herpesvirus infections. Adolescents and young adults comprise an increasing proportion of new HIV infections both in developing and developed countries, and little is known regarding HIV IRIS in this group. As the ART roll-out has gathered pace since 2004 in resource-limited settings, adolescent IRIS has emerged as a clinical challenge. We describe adolescent/young adult patients who presented to our clinic with IRIS events.