Leprosy occurring as immune reconstitution syndrome.

Deps PD, Lockwood DN.

Trans R Soc Trop Med Hyg. 2008 Oct;102(10):966-8. doi: 10.1016/j.trstmh.2008.06.003. Epub 2008 Jul 18.

Immune reconstitution inflammatory syndrome (IRIS) may occur in HIV-infected patients after starting highly active antiretroviral therapy (HAART). Since 2003, 19 cases were published as IRIS. Leprosy has been reported as an example of an IRIS, and it is important that this syndrome should be recognized in leprosy-endemic areas. The case definition of leprosy as IRIS is based on clinical presentation of leprosy, evidence of immune restoration and timing of onset. Case definition should include the following: (1) leprosy and/or leprosy type 1 reaction presenting within six months of starting HAART; (2) advanced HIV infection; (3) low CD4+ count before start HAART; (4) CD4+ count increasing after HAART has been started. Although pathogenic mechanisms are still unclear, it is likely that leprosy-associated IRIS will be increasingly reported in those countries endemic for both diseases and as access to HAART becomes more widely available.

PMID: 18639911

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.