与HIV和麻风病相关的免疫重建炎症综合征
Immune reconstitution inflammatory syndrome associated with HIV and leprosy.
作者信息
Couppié Pierre, Abel Sylvie, Voinchet Hélène, Roussel Morgane, Hélénon Raymond, Huerre Michel, Sainte-Marie Dominique, Cabié André
机构信息
Institut Guyanais de Dermatologie Tropicale, Service de Dermatologie, Centre d'Information et de Soins de l'Immunodéficience Humaine de Guyane, Centre Hospitalier de Cayenne, French Guiana.
出版信息
Arch Dermatol. 2004 Aug;140(8):997-1000. doi: 10.1001/archderm.140.8.997.
BACKGROUND
Immune reconstitution inflammatory syndrome (IRIS) is an unusual inflammatory reaction to an opportunistic infection that occurs in human immunodeficiency virus (HIV)-positive patients with profound immunosuppression during the reconstitution of the immune system in the initial months of highly active antiretroviral treatment.
OBSERVATIONS
We describe 3 cases of leprosy occurring in patients treated with a combination of 3 antiretroviral drugs who fulfilled the criteria for IRIS. A reactional state occurred in all 3 cases. Two of the 3 patients presented an unusual ulcerous progression of the lesions not generally observed in cases of leprosy. The outcome was favorable in all 3 cases. The frequency of IRIS associated with leprosy in French Guiana and Martinique is estimated at 3 cases per 1000 HIV-positive patients receiving highly active antiretroviral treatment.
CONCLUSION
Leprosy should be recognized as an IRIS-associated infection with possibility of atypical presentation.
背景
免疫重建炎症综合征（IRIS）是一种发生在人类免疫缺陷病毒（HIV）阳性患者中的异常炎症反应，这些患者在高效抗逆转录病毒治疗的最初几个月免疫系统重建过程中，处于深度免疫抑制状态，对机会性感染产生反应。
观察结果
我们描述了3例接受3种抗逆转录病毒药物联合治疗且符合IRIS标准的患者发生麻风病的情况。所有3例均出现反应状态。3例患者中有2例出现了麻风病病例中一般未观察到的异常溃疡进展。所有3例预后良好。法属圭亚那和马提尼克岛与麻风病相关的IRIS发生率估计为每1000名接受高效抗逆转录病毒治疗的HIV阳性患者中有3例。
结论
麻风病应被视为一种可能出现非典型表现的与IRIS相关的感染。
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