Immune reconstitution inflammatory syndrome associated with HIV and leprosy

Arch Dermatol. 2004 Aug;140(8):997-1000. doi: 10.1001/archderm.140.8.997.


Background: Immune reconstitution inflammatory syndrome (IRIS) is an unusual inflammatory reaction to an opportunistic infection that occurs in human immunodeficiency virus (HIV)-positive patients with profound immunosuppression during the reconstitution of the immune system in the initial months of highly active antiretroviral treatment.

Observations: We describe 3 cases of leprosy occurring in patients treated with a combination of 3 antiretroviral drugs who fulfilled the criteria for IRIS. A reactional state occurred in all 3 cases. Two of the 3 patients presented an unusual ulcerous progression of the lesions not generally observed in cases of leprosy. The outcome was favorable in all 3 cases. The frequency of IRIS associated with leprosy in French Guiana and Martinique is estimated at 3 cases per 1000 HIV-positive patients receiving highly active antiretroviral treatment.

Conclusion: Leprosy should be recognized as an IRIS-associated infection with possibility of atypical presentation.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / pathology
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / adverse effects
  • Autoimmune Diseases / chemically induced
  • Autoimmune Diseases / diagnosis*
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / pathology
  • Diagnosis, Differential
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / drug therapy
  • Humans
  • Leprostatic Agents / administration & dosage
  • Leprosy / diagnosis*
  • Leprosy / drug therapy
  • Leprosy / pathology
  • Male
  • Middle Aged


  • Anti-HIV Agents
  • Leprostatic Agents