Drain Paul K, Mosam Anisa, Gounder Lilishia, Gosnell Bernadett, Manzini Thandekile, Moosa Mahomed-Yunus S
Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Int J STD AIDS. 2014 Mar;25(3):235-8. doi: 10.1177/0956462413497702. Epub 2013 Jul 19.
We describe an HIV-infected South African man who experienced two distinct episodes of disseminated giant molluscum contagiosum immune reconstitution inflammatory syndrome (IRIS) over a six-year period. The first episode of molluscum contagiosum IRIS occurred with rapid virologic suppression following antiretroviral therapy initiation. The second episode occurred during a rapid increase in CD4 cells following stable viral suppression with second-line antiretroviral therapy. His molluscum contagiosum lesions then completely resolved during a reduction in CD4 count, despite maintaining virologic suppression. Nearly one year after the resolution of his giant molluscum contagiosum IRIS lesions, he maintains an undetectable viral load, but his level of immune deficiency has not improved. In the absence of well-controlled therapeutic trials, molluscum contagiosum IRIS presents important management challenges.
我们描述了一名感染艾滋病毒的南非男子，他在六年时间里经历了两次不同的播散性巨大传染性软疣免疫重建炎症综合征（IRIS）发作。第一次传染性软疣IRIS发作发生在开始抗逆转录病毒治疗后病毒迅速被抑制时。第二次发作发生在二线抗逆转录病毒治疗使病毒稳定抑制后CD4细胞快速增加期间。尽管病毒载量维持在可检测水平以下，但在CD4细胞计数下降期间，他的传染性软疣病变随后完全消退。在他的巨大传染性软疣IRIS病变消退近一年后，他的病毒载量仍检测不到，但免疫缺陷水平并未改善。在缺乏严格对照的治疗试验的情况下，传染性软疣IRIS带来了重要的管理挑战。
