
Paradoxical Reactions of Tuberculosis in Patients With the Acquired Immunodeficiency Syndrome Who Are Treated With Highly Active Antiretroviral Therapy
Arch Intern Med. 2002;162:97-99.
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The administration of highly active antiretroviral therapy (HAART) has
produced a significant decrease in acquired immunodeficiency syndromerelated
opportunistic infections, but also has changed the natural history and the
usual presentation of some of these infections.1-4
Soon after the introduction of combination regimens that included protease
inhibitors, several researchers reported unusual clinical features in patients
who developed opportunistic diseases after the initiation of HAART. The new
clinical features have been well described for disseminated Mycobacterium avium complex disease5
and for cytomegalovirus retinitis,6 and
were given the generic name of "reactivation syndrome" or "immune reconstitution
syndrome." This syndrome was attributed to the immunologic recovery produced
by HAART, which could enhance the inflammatory response around the infection,
producing either a relapse of clinical symptoms or the appearance of new-onset
opportunistic infections.7
Descriptions of this syndrome in human immunodeficiency virus (HIV)infected
patients with tuberculosis were also reported after the introduction of protease
inhibitors.8-11
Later . . . [Full Text of this Article] Patients and Methods
Results
Comment
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