Prevalence, clinical manifestations and predictors of immune reconstitution inflammatory syndrome among HIV-infected patients in Malaysia infectious disease centre: a retrospective study
Introduction: Immune reconstitution inflammatory syndrome (IRIS) is paradoxical clinical deterioration experienced by some HIV-infected patients in response to antiretroviral therapy (ART). There is still limited published data on IRIS from this region including Malaysia. This study aimed to deter...
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| Format: | Article |
| Language: | English |
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Faculty of Medicine and Health Sciences, University Putra Malaysia
2020
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| Online Access: | http://psasir.upm.edu.my/id/eprint/87289/ http://psasir.upm.edu.my/id/eprint/87289/1/2020110610581806_2020_0393.pdf |
| _version_ | 1848860407703273472 |
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| author | Kamarudin, Nurul Suhaili Mohd Taib, Niazlin Zaini, Adilahtul Bushro Mahayidin, Hasni |
| author_facet | Kamarudin, Nurul Suhaili Mohd Taib, Niazlin Zaini, Adilahtul Bushro Mahayidin, Hasni |
| author_sort | Kamarudin, Nurul Suhaili |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | Introduction: Immune reconstitution inflammatory syndrome (IRIS) is paradoxical clinical deterioration experienced
by some HIV-infected patients in response to antiretroviral therapy (ART). There is still limited published data on
IRIS from this region including Malaysia. This study aimed to determine IRIS prevalence, clinical manifestations
and possible predictors among HIV-infected patients in an infectious disease centre in Peninsular Malaysia.
Method: This retrospective study was conducted in Hospital Sungai Buloh involving secondary data of 256
HIV-infected patients who were initiated on ART in the year 2017. Medical record of each patient was reviewed
for up to 12 months following ART initiation to identify IRIS diagnosis which was made by the treating physician.
Relevant clinical and laboratory information were retrieved from hospital electronic database. Results: IRIS has
occurred in 17.6% of patients. Infections by Mycobacterium tuberculosis (53.3%), Pneumocystis jirovecii (11.1%)
and Talaromyces marneffei (6.6%) were the commonest three aetiologies of IRIS. Subacute lupus erythematosus was
the only non-infectious IRIS identified. Baseline HIV viral load, CD4+ T-cell count and haemoglobin level between
IRIS and non-IRIS patients were significantly different. Risk of developing IRIS was increased seven times in patients
with CD4+ T-cell count < 100 cells/µL and four times in patients with HIV RNA viral load > 5.5 log10 copies/ml prior
to ART initiation. Conclusion: Mycobacterium tuberculosis infections were the highest IRIS manifestation. Although
rare, non-infectious IRIS does occur and should be part of the differential diagnosis. Patients with positive predictors
should be appropriately monitored for possible IRIS development once initiated on ART. |
| first_indexed | 2025-11-15T12:44:45Z |
| format | Article |
| id | upm-87289 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T12:44:45Z |
| publishDate | 2020 |
| publisher | Faculty of Medicine and Health Sciences, University Putra Malaysia |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-872892022-02-03T08:35:19Z http://psasir.upm.edu.my/id/eprint/87289/ Prevalence, clinical manifestations and predictors of immune reconstitution inflammatory syndrome among HIV-infected patients in Malaysia infectious disease centre: a retrospective study Kamarudin, Nurul Suhaili Mohd Taib, Niazlin Zaini, Adilahtul Bushro Mahayidin, Hasni Introduction: Immune reconstitution inflammatory syndrome (IRIS) is paradoxical clinical deterioration experienced by some HIV-infected patients in response to antiretroviral therapy (ART). There is still limited published data on IRIS from this region including Malaysia. This study aimed to determine IRIS prevalence, clinical manifestations and possible predictors among HIV-infected patients in an infectious disease centre in Peninsular Malaysia. Method: This retrospective study was conducted in Hospital Sungai Buloh involving secondary data of 256 HIV-infected patients who were initiated on ART in the year 2017. Medical record of each patient was reviewed for up to 12 months following ART initiation to identify IRIS diagnosis which was made by the treating physician. Relevant clinical and laboratory information were retrieved from hospital electronic database. Results: IRIS has occurred in 17.6% of patients. Infections by Mycobacterium tuberculosis (53.3%), Pneumocystis jirovecii (11.1%) and Talaromyces marneffei (6.6%) were the commonest three aetiologies of IRIS. Subacute lupus erythematosus was the only non-infectious IRIS identified. Baseline HIV viral load, CD4+ T-cell count and haemoglobin level between IRIS and non-IRIS patients were significantly different. Risk of developing IRIS was increased seven times in patients with CD4+ T-cell count < 100 cells/µL and four times in patients with HIV RNA viral load > 5.5 log10 copies/ml prior to ART initiation. Conclusion: Mycobacterium tuberculosis infections were the highest IRIS manifestation. Although rare, non-infectious IRIS does occur and should be part of the differential diagnosis. Patients with positive predictors should be appropriately monitored for possible IRIS development once initiated on ART. Faculty of Medicine and Health Sciences, University Putra Malaysia 2020-11 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/87289/1/2020110610581806_2020_0393.pdf Kamarudin, Nurul Suhaili and Mohd Taib, Niazlin and Zaini, Adilahtul Bushro and Mahayidin, Hasni (2020) Prevalence, clinical manifestations and predictors of immune reconstitution inflammatory syndrome among HIV-infected patients in Malaysia infectious disease centre: a retrospective study. Malaysian Journal of Medicine and Health Sciences, 16 (suppl. 9). 38 - 45. ISSN 2636-9346 https://medic.upm.edu.my/upload/dokumen/2020110610581806_2020_0393.pdf |
| spellingShingle | Kamarudin, Nurul Suhaili Mohd Taib, Niazlin Zaini, Adilahtul Bushro Mahayidin, Hasni Prevalence, clinical manifestations and predictors of immune reconstitution inflammatory syndrome among HIV-infected patients in Malaysia infectious disease centre: a retrospective study |
| title | Prevalence, clinical manifestations and predictors of immune reconstitution inflammatory syndrome among HIV-infected patients in Malaysia infectious disease centre: a retrospective study |
| title_full | Prevalence, clinical manifestations and predictors of immune reconstitution inflammatory syndrome among HIV-infected patients in Malaysia infectious disease centre: a retrospective study |
| title_fullStr | Prevalence, clinical manifestations and predictors of immune reconstitution inflammatory syndrome among HIV-infected patients in Malaysia infectious disease centre: a retrospective study |
| title_full_unstemmed | Prevalence, clinical manifestations and predictors of immune reconstitution inflammatory syndrome among HIV-infected patients in Malaysia infectious disease centre: a retrospective study |
| title_short | Prevalence, clinical manifestations and predictors of immune reconstitution inflammatory syndrome among HIV-infected patients in Malaysia infectious disease centre: a retrospective study |
| title_sort | prevalence, clinical manifestations and predictors of immune reconstitution inflammatory syndrome among hiv-infected patients in malaysia infectious disease centre: a retrospective study |
| url | http://psasir.upm.edu.my/id/eprint/87289/ http://psasir.upm.edu.my/id/eprint/87289/ http://psasir.upm.edu.my/id/eprint/87289/1/2020110610581806_2020_0393.pdf |