Leishmaniasis as a manifestation of immune reconstitution inflammatory syndrome (IRIS) in HIV-infected patients: A literature review


INTRODUCTION: After the onset of highly active antiretroviral therapy (HAART), some HIV-infected patients present a severe inflammation in response to a latent or a previously treated opportunistic pathogen termed immune reconstitution inflammatory syndrome (IRIS). Few reports of tegumentary and visceral leishmaniasis have been described in association with IRIS. METHODS: A systematic literature review of IRIS in association with leishmaniasis identified 34 reported cases. RESULTS AND DISCUSSION: The majority of these occurred in males 4 months following the onset of HAART. The mean CD4 count before HAART was 94 +/- 77 cells/mm(3) increasing to 5 times the initial value between the onset of HAART and IRIS presentation. Visceral leishmaniasis and post-kala-azar dermal leishmaniasis were the most commonly reported clinical manifestations, followed by tegumentary leishmaniasis and uveitis. CONCLUSIONS: Commonly found characteristics included cutaneous involvement, regardless of Leishmania species; appearance of lesions unrelated to time of probable Leishmania infection; rapid recovery of CD4 count following HAART; and rapid progression.


Badaró R, Gonçalves LO, Gois LL, Maia ZP, Benson C, Grassi MF.




  • Population(s)
    • General HIV+ population
  • Engagement and Care Cascade
    • Treatment
  • Co-infections
    • Other


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