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  <TITLE>Huruy et al., Immune Reconstitution Inflammatory Syndrome</TITLE>

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<P>Jpn. J. Infect. Dis., 61 (3), 205-209, 2008</P>


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<P>Original Article</P>


<P><B><FONT SIZE="+2">Immune Reconstitution Inflammatory Syndrome among HIV/AIDS Patients during Highly Active Antiretroviral Therapy in Addis Ababa, Ethiopia</FONT></B></P>


<P><B>Kahsay Huruy*, Andargachew Mulu<FONT SIZE="-1"><sup>1</sup></Font>, Getahun Mengistu<FONT SIZE="-1"><sup>2</sup></Font>, 

Aster Shewa-Amare<FONT SIZE="-1"><sup>3</sup></Font>, Addis Akalu<FONT SIZE="-1"><sup>3</sup></Font>, 

Afework Kassu<FONT SIZE="-1"><sup>1</sup></Font>, Gashaw Andargie<FONT SIZE="-1"><sup>4</sup></Font>, 

Daniel Elias<FONT SIZE="-1"><sup>1</sup></Font> and Workineh Torben<FONT SIZE="-1"><sup>5,6</sup></Font></B></P>


<P>Department of Medical Laboratory Technology, 

<FONT SIZE="-1"><sup>1</sup></Font>Department of Microbiology and Parasitology and 

<FONT SIZE="-1"><sup>4</sup></Font>School of Public Health, College of Medicine and Health Sciences, 

University of Gondar, Gondar;

<FONT SIZE="-1"><sup>2</sup></Font>Department of Neurology, Faculty of Medicine and 

<FONT SIZE="-1"><sup>5</sup></Font>Aklilu Lemma Institute of Pathobiology, Addis Ababa University; 

<FONT SIZE="-1"><sup>3</sup></Font>Zewditu Memorial Hospital, Addis Ababa, Ethiopia; and

<FONT SIZE="-1"><sup>6</sup></Font>Texas Tech University Health Sciences Center, School of Medicine, 

Microbiology and Immunology, Texas, USA</P>


<P>(Received January 30, 2008. Accepted March 31, 2008)</P>


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<P>*Corresponding author: Mailing address: Department of Medical Laboratory Technology, 

College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia. 

Tel: +251-911771518, E-mail: kasaye88@yahoo.com</P>


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<P><B>SUMMARY</B>: Suppression of viral replication is followed by increases in CD4<sup>+</sup> lymphocytes, and 

this has been shown to result in decreased susceptibility to opportunists after initiation of highly active antiretroviral 

therapy (HAART). However, clinical aggravations after the initiation of HAART have been thought to be due to the restored 

ability to mount an inflammatory response, or the immune reconstitution inflammatory syndrome (IRIS). The degree of IRIS 

observed in human immunodeficiency virus (HIV)-infected patients following initiation of HAART is variable. This prospective 

study was aimed at determining the proportion of IRIS and the pattern of opportunistic infections among 186 HIV/AIDS patients 

receiving HAART between December 2006 and July 2007 at Zewditu Memorial Hospital, Addis Ababa, Ethiopia. The proportion of 

IRIS was 17.2% (32/186). The mean number of days of IRIS occurrence for each disease ranged from 26 to 122 days with a mean 

of 80. Opportunistic diseases associated with IRIS were tuberculosis (68.8%, 22/32), herpes zoster rash (12.5%, 4/32), 

cryptococcosis (9.4%, 3/32), toxoplasmosis (6.3%, 2/32) and bacterial pneumonia (3.1%, 1/32). Compared to baseline readings 

there were significant increases in CD4 count, aspartate aminotransferase and alanine aminotransferase levels while hemoglobin 

values decreased during the development of IRIS. In summary, the proportion of IRIS and the pattern of opportunistic 

infections in HAART-treated patients in Ethiopia mirrored those reported in other countries. Further prospective surveys on epidemiological, immunological, microbial and clinical studies are imperative to assess the proportion and pattern of IRIS and effect of HAART in Ethiopia.</P>


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