Original Research

Immune reconstitution inflammatory syndrome in children

Helena Rabie, Tammy Meyers, Mark F Cotton
Southern African Journal of HIV Medicine | Vol 10, No 4 | a263 | DOI: https://doi.org/10.4102/sajhivmed.v10i4.263 | © 2009 Helena Rabie, Tammy Meyers, Mark F Cotton | This work is licensed under CC Attribution 4.0
Submitted: 15 December 2009 | Published: 14 December 2009

About the author(s)

Helena Rabie, Department of Paediatrics and Child Health Tygerberg Children’s Hospital and Stellenbosch University, South Africa
Tammy Meyers, Harriet Shezi Paediatric ARV Clinic at Chris Hani Baragwanath Hospital, South Africa
Mark F Cotton, KIDCRU and Department of Paediatrics and Child Health Tygerberg Children’s Hospital and Stellenbosch University, South Africa

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Abstract

Paradoxical deterioration due to immune reconstitution inflammatory syndrome (IRIS) occurs in up to 21% of children initiating antiretroviral therapy. Mycobacterial diseases are the most common, with BCG-vaccine adenitis predominating in infants and M. tuberculosis (TB) in older children. The difficulty of diagnosing TB in HIV-infected children and the increasing risk of drug-resistant TB complicate the diagnosis and management of both paradoxical IRIS and post-antiretroviral therapy TB. History and clinical assessment remain key strategies in the management of these infants and children. There are no prospective studies investigating diagnostic criteria and therapeutic strategies in children.

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