Table 4.

Clinical, virologic, and outcome data in seven patients with histoplasmosis-related IRIS, France^*

Patient no.	Age, y/sex	Time interval, months†	Baseline‡			IRIS
			CD4 cells/μL	Viral load (copies/mL)	Manifestation	CD4 cells/μL	Viral load (copies/mL)	Manifestation
1	51/F	0	25	350,000	None	144	< 50	Peripheral necrotic adenopathies
2§	33/M§	0	13	250,000	None	59	150	Hemophagocytic syndrome
3§	57/M§	1	55	> 500,000	Pulmonary involvement	436	< 200	Intestinal obstruction caused by granulomatous colitis
4§	20/F§	2	4	196,000	Papule and hepatomegaly	108	25,000	Arthritis, uveitis
5	29/F	43¶	92	3,328,000	Meningitis	113	68,000	Aseptic meningitis
6	51/M	2	14	1,000,000	Splenomegaly and peripheral adenopathies	180	< 50	Rash
7§	36/M§	35¶	2	290,000	Hepatosplenomegaly and peripheral adenopathies	106	< 50	Peripheral necrotic adenopathies

^*IRIS = immune reconstitution inflammatory syndrome.

^†Time interval is the period between diagnosis of histoplasmosis and IRIS.

^‡Baseline was diagnosis of acquired immunodeficiency syndrome (AIDS). AIDS was detected by histoplasmosis for all patients except patients 1 and 2 for whom IRIS was the first manifestation of histoplasmosis. Patient 1 was treated with chemotherapy and highly active anti-retroviral therapy (HAART) for Kaposi's sarcoma. Histoplasmosis-related adenopathy appeared three months after onset of HAART, when chemotherapy was stopped. Patient 2 had AIDS-defining toxoplasmosis and onset of HAART three weeks before IRIS.

^§These patients have been reported.¹¹,¹⁷

^¶These two patients had an unplanned interruption of HAART and became compliant again 2 months before IRIS. No immunovirologic data were available during HAART interruption.