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The clinical pattern, prevalence, and factors associated with immune reconstitution inflammatory syndrome in Ugandan

Judy Orikiiriza1, Sabrina Bakeera-Kitaka, Victor Musiime

  • 1Department of Pediatrics and Child Health, Makerere University College of Health Sciences and Mulago National Referral Hospital, Uganda. jtatorichdr@yahoo.com

AIDS (London, England)
|July 10, 2010
PubMed

Insights

Pediatric immune reconstitution inflammatory syndrome (IRIS) affects 38% of HIV-infected children in Uganda, often presenting early after antiretroviral therapy (ART) initiation. Key risk factors include low pre-ART CD4 counts and male sex, necessitating increased awareness among healthcare providers and caregivers.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Global Health

Background:

  • Immune reconstitution inflammatory syndrome (IRIS) is a significant concern in children initiating antiretroviral therapy (ART), particularly in resource-limited settings.
  • Understanding the clinical patterns and prevalence of pediatric IRIS is crucial for effective management.

Purpose of the Study:

  • To determine the clinical pattern, prevalence, and associated factors of pediatric IRIS in Uganda.
  • To identify risk factors for IRIS in HIV-infected children starting ART.

Main Methods:

  • A prospective, multicenter cross-sectional study was conducted in Uganda.
  • 162 HIV-infected children receiving ART for 0.5-6 months were evaluated for IRIS using a standardized case definition.

Main Results:

  • The prevalence of IRIS was 38%, with 77% being unmasking of new opportunistic infections.
  • Tuberculosis-IRIS was the most frequent presentation (29%), often occurring within the first month of ART.
  • Independent risk factors included low pre-ART CD4(+) cell percentage, high current CD8(+) cell count, male sex, and prolonged cough.

Conclusions:

  • IRIS is common in Ugandan children with advanced immunosuppression starting ART, frequently occurring early in treatment.
  • Awareness of IRIS among healthcare providers and caregivers is essential to prevent ART nonadherence and improve patient outcomes.
Abstract

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