Atipo-Tsiba P W, Kombo Bayonne E S
Department of Ophthalmology, University Hospital of Brazzaville.
Department of Medicinel (Dermatology unit), Talangaï Hospital of Brazzaville.
Ethiop J Health Sci. 2016 May;26(3):297-300. doi: 10.4314/ejhs.v26i3.14.
In countries with high prevalence of HIV/AIDS infection, particularly in black Africa, shingles is one of the main opportunistic infections during immunosuppression due to AIDS in young patients. If immunological weakness is important, usually when the CD4 cell count is less than 100 cells/mm(3), the risk of inflammatory reactions in the first three months after initiating of antiretroviral treatment (ART) is very high. This inflammatory reaction is called immune reconstitution inflammatory syndrome (IRIS). This observation reports the first documented case of IRIS with V1 shingles in a young HIV patient at University Hospital of Brazzaville.
A 40 years old patient was seen for a pain of the right side of the face and a complete immobility of the eyeball. The diagnosis of V1 shingles with a pan uveitis, and a paralysis of III, IV and VI nerves was made. The patiants HIV status was positive and CD4 cell count was 150 cells/mm(3). After two months of evolution under ART with a CD4 count of 850 cells /mm(3), the symptomatology was quickly complicated by significant inflammation causing a phtisis bulbi.
CD4 cells count is an important indicator in the HIV/AIDS therapy. In some major forms of IRIS, momentary pause of anti retroviral treatment is sometimes necessary.
在艾滋病毒/艾滋病感染率高的国家，尤其是在黑非洲，带状疱疹是年轻患者因艾滋病导致免疫抑制期间主要的机会性感染之一。如果免疫功能低下很严重，通常是在CD4细胞计数低于100个细胞/mm³时，开始抗逆转录病毒治疗（ART）后的头三个月发生炎症反应的风险非常高。这种炎症反应称为免疫重建炎症综合征（IRIS）。本观察报告了在布拉柴维尔大学医院一名年轻艾滋病毒患者中首例有记录的伴有V1带状疱疹的IRIS病例。
一名40岁患者因面部右侧疼痛和眼球完全不能活动前来就诊。诊断为伴有全葡萄膜炎的V1带状疱疹，以及第三、第四和第六神经麻痹。该患者艾滋病毒检测呈阳性，CD4细胞计数为150个细胞/mm³。在接受ART治疗两个月后，CD4计数达到850个细胞/mm³，症状迅速因严重炎症而复杂化，导致眼球萎缩。
CD4细胞计数是艾滋病毒/艾滋病治疗中的一个重要指标。在某些主要形式的IRIS中，有时需要暂时停止抗逆转录病毒治疗。
