Document Detail


Varicella-zoster virus vasculopathy and central nervous system immune reconstitution inflammatory syndrome with human immunodeficiency virus infection treated with steroids.
MedLine Citation:
PMID:  19444693     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Immune reconstitution inflammatory syndrome (IRIS) is widely recognized and rarely involves the central nervous system (CNS). Patients with acquired immunodeficiency syndrome (AIDS) are at an increased risk for developing CNS-IRIS upon initiation of highly active antiretroviral therapy (HAART). This syndrome can be fatal and requires extreme vigilance in determining if a treatable underlying opportunistic infection exists. We report here a case of varicella-zoster virus (VZV) vasculopathy and CNS-IRIS in a human immunodeficiency virus (HIV)-infected patient who required prolonged steroid treatment for clinical stabilization. There are no established treatment regimens for IRIS and the use of corticosteroids in this syndrome remains controversial. Similar to our patient, severe cases of CNS-IRIS may benefit from high-dose intravenous corticosteroid treatment followed by an oral prednisone taper.
Authors:
Scott D Newsome; Avindra Nath
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurovirology     Volume:  15     ISSN:  1538-2443     ISO Abbreviation:  J. Neurovirol.     Publication Date:  2009 May 
Date Detail:
Created Date:  2010-07-02     Completed Date:  2010-10-06     Revised Date:  2011-03-29    
Medline Journal Info:
Nlm Unique ID:  9508123     Medline TA:  J Neurovirol     Country:  England    
Other Details:
Languages:  eng     Pagination:  288-91     Citation Subset:  IM    
Affiliation:
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore 21287, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / complications*,  drug therapy
Adult
Anti-HIV Agents / therapeutic use
Anti-Inflammatory Agents / therapeutic use*
Antiretroviral Therapy, Highly Active
DNA, Viral / cerebrospinal fluid
Encephalitis, Varicella Zoster / etiology*
Female
HIV-1*
Herpesvirus 3, Human / genetics,  isolation & purification*
Humans
Immune Reconstitution Inflammatory Syndrome / drug therapy*
Methylprednisolone / therapeutic use*
Vasculitis, Central Nervous System / etiology*
Grant Support
ID/Acronym/Agency:
R01 NS056884/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Anti-Inflammatory Agents; 0/DNA, Viral; 83-43-2/Methylprednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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