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Is acute appendicitis another inflammatory condition associated with highly active antiretroviral therapy (HAART)?
T Aldeen1, M Horgan, D C Macallan
1Department of Genitourinary Medicine, St George's Hospital, London, UK.
Objective:
To report the occurrence of acute appendicitis as a possible manifestation of the immune restoration inflammatory syndrome (IRIS) following the commencement of highly active antiretroviral therapy (HAART) in HIV patients.
Design:
Case-note review of HIV patients on HAART with acute appendicitis.
Methods:
Review of HIV markers, antiretroviral therapy and abdominal ultrasound results of four HIV patients with acute appendicitis and the histopathology reports on the appendix in two of the patients.
Results:
From a population of approximately 350 HIV patients on HAART, we found four patients who developed acute appendicitis within 6 months of commencing or changing HAART.
Conclusion:
Acute appendicitis occurring in HIV patients on HAART may represent a variant of IRIS. Further immunohistopathological and epidemiological evaluation will be needed to define this relationship fully.