Immune Reconstitution Syndrome in HIV-1 infected children - a study from India

To determine incidence of Immune Reconstitutional Syndrome (IRIS) in HIV infected children and also to determine risk factors associated with it.

Thirty-seven HIV infected children who were started on Antiretroviral therapy (ART) in past 2 years were included in the study. Statistical Analysis was done using Chi Square test.

Seven patients (18.9%) had IRIS at a mean interval of 1.7 ± 0.8 months. Two patients (28.6%) had tuberculosis (TB), 2 patient (28.6%) had herpes zoster and 1 patient (14.3%) each had pneumonia, toxoplasmosis and esophageal candidiasis. There was no significant difference as per age (p = 0.8), WHO Stage of disease (p = 0.93), Sex (0.45), type of antiretroviral regime (p = 0.38) and severity of immune suppression (0.98). It was found that patients with opportunistic infections (OIs) before treatment would have increased incidence of IRIS (p = 0.05). The mean OIs/year prior to treatment in patients with IRIS was 2.6 ± 1.4 vs. 1.7 ± 1.2.

Incidence of IRIS in HIV infected children in Mumbai is 18.9%. Patients with OIs before treatment with ART have an increased incidence of IRIS. Clinical stage of disease or degree of immune suppression prior to treatment had no effect on incidence of IRIS.