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Identifying Dysregulated Genes Induced by Kaposi's Sarcoma-associated Herpesvirus KSHV

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[A paradox: sarcoidosis in an HIV-positive patient]

Coen van Kan¹, Jan Peringa, Armin W Walter

¹Onze Lieve Vrouwe Gasthuis, Amsterdam.

Nederlands Tijdschrift Voor Geneeskunde

|January 8, 2015

Abstract

Background:

In view of the diminished number of CD4+ lymphocytes, the co-existence of an HIV infection and sarcoidosis seems paradoxical. Immune reconstitution inflammatory syndrome (IRIS) may be observed in response to anti-retroviral therapy (ART). According to the conventional definition, this is caused by an overwhelming immune response to an already present or to a new agent.

Case Description:

We describe the case of a 47-year-old HIV-positive patient, who presented with an exacerbation of his sarcoidosis nine months after initiation of ART. Based on the time course and the dynamics of the CD4+ lymphocyte count, this presentation of disease can be placed in the context of IRIS.

Conclusion:

The presentation or exacerbation of sarcoidosis after initiation of antiretroviral therapy in HIV-positive patients with a low CD4+ count at start of therapy can be placed in the context of IRIS.

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