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Published on: June 14, 2024
Immune reconstitution inflammatory syndrome associated with HIV and leprosy
Pierre Couppié1, Sylvie Abel, Hélène Voinchet
1Institut Guyanais de Dermatologie Tropicale, Service de Dermatologie, Centre d'Information et de Soins de l'Immunodéficience Humaine de Guyane, Centre Hospitalier de Cayenne, French Guiana. couppie.pierre@voila.fr
Background:
Immune reconstitution inflammatory syndrome (IRIS) is an unusual inflammatory reaction to an opportunistic infection that occurs in human immunodeficiency virus (HIV)-positive patients with profound immunosuppression during the reconstitution of the immune system in the initial months of highly active antiretroviral treatment.
Observations:
We describe 3 cases of leprosy occurring in patients treated with a combination of 3 antiretroviral drugs who fulfilled the criteria for IRIS. A reactional state occurred in all 3 cases. Two of the 3 patients presented an unusual ulcerous progression of the lesions not generally observed in cases of leprosy. The outcome was favorable in all 3 cases. The frequency of IRIS associated with leprosy in French Guiana and Martinique is estimated at 3 cases per 1000 HIV-positive patients receiving highly active antiretroviral treatment.
Conclusion:
Leprosy should be recognized as an IRIS-associated infection with possibility of atypical presentation.
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