HIV immune reconstitution syndrome in sub-Saharan Africa

Abstract

Over the last 5 years, there has been remarkable progress in providing HAART to patients in developing countries. In sub-Saharan Africa alone, the number receiving antiretroviral therapy (ART) has more than doubled in the last year, from 300 000 to 810 000. It has long been anticipated that with large numbers initiating ART in these settings, HIV immune reconstitution inflammatory syndrome (IRIS) would be a major problem, because of the low CD4 cell count at ART initiation and high underlying prevalence of infections such as Mycobacterium tuberculosis, and Cryptococcus neoformans. Although the phenomenon of IRIS has been extensively described, the impact of IRIS on ART-related outcomes in resourcepoor settings has not been well documented.