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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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May 25, 2005

I'm a 50 yo man VIH positive since 1992, cd4=970 VL=<0. My treatment is: Emtriva 200mg qid, Norvir 100mg bid, Lexiva 700mg bid, Viread 300mg qid. In 2001 I got NHL cd4=900 VL= <0 and was treated with CHOP, m-BACOD and Rituxan, my type of NHL was Diffuse Large B cells. Now I'm having some problems with my lymph nodes again, on May 27 I'll have a excisional biopse in my neck.

My question is: My problems can be related to IRIS? and Where can I learn more about IRIS?

My Dr. is planing a treatment called R-ICE and later autologous BMT.


Response from Dr. Conway

Immune Reconstitution Inflammatory Syndrome (IRIS) is a worsening of a person's state of health that follows the initiation of HAART. It results from the fact that your immune system is suddenly turned on and rapidly improving, and releasing a number of inflammatory mediators into your system. As the lymph nodes are part of the immune system, they can be enlarged in the process.

The following article is quite interesting:

Powles T, Thirlwell C, Nelson M, Bower M. Immune reconstitution inflammatory syndrome mimicking relapse of AIDS related lymphoma in patients with HIV 1 infection. Leuk Lymphoma. 2003 Aug;44(8):1417-9.

It presents 3 cases of IRIS that were initially thought to be relapses of non-Hodgkin's lymphoma. In your case, the biopsy of the lymph node will be the key to differentiating IRIS from NHL from anything else that could be causing the problem.

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