Race E, Adelson-Mitty J, Barlam T, Japour A; Conference on Retroviruses and Opportunistic Infections.
Program Abstr 4th Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 4th 1997 Wash DC. 1997 Jan 22-26; 4th: 129 (abstract no. 352).
Beth Israel Deaconess Medical Center, Boston, MA.
We report the development of severe febrile reactions and FIL in 3 patients with CD4 counts of less than 50 cells/mm3 and unrecognized Mycobacterium avium complex (MAC) infection following PRI therapy. 6 to 21 days after PRI was begun, all 3 patients presented with fever ranging from 103-106F. Examinations revealed FIL in all patients. The Table below shows the characteristics of the 3 patients. In addition to the leukocytosis, the patients showed a striking increase in their absolute lymphocyte counts. PRI was interrupted due to concern over drug fever. However, fever evaluation revealed previously unsuspected MAC infection in all 3 patients. The diagnosis of MAC infection was established by culture or pathology. One patient was re-challenged with PRI a month later, and developed recurrent fever, leukocytosis and FIL, which again resolved when PRI was discontinued. The development of fever, leukocytosis and FIL in patients with unrecognized MAC infection suggests that PRI may be stimulating antigen-specific T cell-mediated inflammatory reactions. The severity of illness in patients with heavily localized but untreated MAC infection following initiation of PRI therapy suggests that patients with advanced HIV-1 infection should be evaluated for the presence of unrecognized MAC infection prior to the initiation of PRI. (Table: see text).
Publication Types:
Keywords:
- Antigens, CD4
- Communicable Diseases
- Fever
- HIV Protease Inhibitors
- HIV-1
- Humans
- Leukocytosis
- Lymphadenitis
- Mycobacterium avium Complex
- Mycobacterium avium-intracellulare Infection
- Protease Inhibitors
- Tuberculosis, Lymph Node
- diagnosis
- immunology
Other ID:
UI: 102223621
From Meeting Abstracts