Immune Reconstitution Inflammatory Syndrome in Aids Patient After Successful Induction of Virological Suppression with Cabotegravir/Rilpivirine.
AIDS
Cabotegravir/rilpivirine
HIV
IRIS
immune reconstitution inflammatory syndrome
Journal
European journal of case reports in internal medicine
ISSN: 2284-2594
Titre abrégé: Eur J Case Rep Intern Med
Pays: Italy
ID NLM: 101648453
Informations de publication
Date de publication:
2023
2023
Historique:
received:
17
06
2023
accepted:
21
06
2023
medline:
9
8
2023
pubmed:
9
8
2023
entrez:
9
8
2023
Statut:
epublish
Résumé
Long-acting (LA) cabotegravir/rilpivirine (CAB/RPV) is a complete regimen for the management of human immunodeficiency virus type 1 (HIV-1) infection to replace their oral antiretroviral therapy (ART) when they have been virologically suppressed. We present a case of successful achievement of undetectable HIV RNA viral load levels in an acquired immunodeficiency syndrome (AIDS) patient with long-standing virologic failure within two months of CAB/RPV LA initiation. This was later complicated by immune reconstitution inflammatory syndrome (IRIS) due to This case highlights the efficacy of monthly CAB/RPV LA in rapidly reducing the HIV viral load level in a poorly controlled patient who lacked significant resistance to the two drugs.This is the first case of IRIS reported in the literature while using CAB/RPV LA. IRIS in the setting of occult MAI is well recognised. It would have occurred with good adherence to any regimen which rapidly suppressed the viral load and is unlikely to be due to CAB/RPV. CAB/RPV has no activity against HBV, which may have contributed to its reactivation.The patient had serologic evidence of resolution of prior HBV. However, some patients have covalently closed circular DNA (cccDNA) that may remain long term in hepatocyte nuclei.
Identifiants
pubmed: 37554471
doi: 10.12890/2023_003981
pii: 3981
pmc: PMC10405873
doi:
Types de publication
Journal Article
Langues
eng
Pagination
003981Informations de copyright
© EFIM 2023.
Déclaration de conflit d'intérêts
Conflicts of Interests: The Authors declare that there are no competing interests.
Références
J Acquir Immune Defic Syndr. 2020 Dec 1;85(4):498-506
pubmed: 33136751
N Engl J Med. 2020 Mar 19;382(12):1112-1123
pubmed: 32130809
Lancet HIV. 2021 Nov;8(11):e679-e689
pubmed: 34648734
JAMA. 2013 Oct 23;310(16):1664
pubmed: 24150447
Clin Infect Dis. 2023 Feb 8;76(3):e645-e651
pubmed: 35913500
Adv Ther. 2021 Sep;38(9):4961-4974
pubmed: 34390465
Adv Dent Res. 2011 Apr;23(1):90-6
pubmed: 21441488
Hepatology. 2017 May;65(5):1451-1461
pubmed: 28027590
PLoS Med. 2016 Nov 29;13(11):e1002183
pubmed: 27898679