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Jun 22, 2007

What is Immune reconstitution syndrome?

Response from Dr. Henry

Immune reconstitution syndrome refers to a range of conditions that are seen during the period after potent antietroviral therapy is started. During that time the immune system often begins recovering from the damage that had occurred-most often assessed by an increasing CD4 count. Many HIV + patients have a range of HIV-associated infections (such as TB, atypical mycobacteria, cytomegalovirus, and others) that are smouldering /somewhat hidden since both the symptoms and control of those infections relate to the immune system. When the immune system starts functioning better then there can be a flare-up of symptoms due to those other infections. That is very frustrating since those symptoms can mimic a range of problems including side effects from some of the HIV drugs. In fact, immune reconstitution syndrome is one of the major challenges in HIV care particularly in many resource poor regions with high rates of comcommittant TB and other infections. In summary, IRS is a frustrating manifestation of often otherwise effective treatment that can be very challenging to manage.


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