Immune reconstitution syndromes in human immunodeficiency virus infection following effective antiretroviral therapy

Effective antiretroviral therapy leads to rapid decrease in plasma HIV-I RN A, frequently followed by an increase in CD4 T-helper cell counts. The impr ovement of immune function during highly active antiretroviral therapy has important impact on natural history of AIDS-related opportunistic disorders . Here we describe cases of unusual clinical inflammatory syndromes in CMV retinitis, hepatitis C, and atypical mycobacteriosis in HIV-1 infected pati ents associated with the initiation of antiretroviral therapy. Pathogenetic implications and therapeutic management of these new immunopathologic synd romes are discussed.