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Incidence of Immune Reconstitution Inflammatory Syndrome in HIV Infected Children in Peru M.E. Wang1, M.E. Castillo2, J.R. Zunt3 1Stanford University School of Medicine, Stanford, USA 2Instituto Nacional de Salud del Niño, Infectious Diseases Service, Lima, Peru, 3University of Washington, Departments of Neurology, Global Health and Medicine (Infectious Diseases), Seattle, USA Research supported by the NIH/Fogarty International Clinical Research Scholars Program Introduction IRIS: Clinical deterioration due to an infectious or inflammatory response shortly after the start of HAART therapy, with concurrent immune recovery 10-32% incidence in adults, 19% in children Methods Retrospective Population: All children starting HAART at the Instituto Nacional de Salud del Niño, Peru, 2002-06 IRIS Definition: Occurrence of a condition previously associated with IRIS within a year of starting HAART, in a patient with virologic or immunologic success Results 91 patients evaluated 19.8% (18/91) of patients developed IRIS • 33% of cases (6/18) from Mycobacterium spp. M. tuberculosis – 5 cases BCG adenitis – 1 case • 33% of cases (6/18) from varicella zoster virus • 33% of cases (6/18) from herpes simplex labialis All cases resolved, no IRIS related mortality Median time to onset: 6.6 weeks (Range 2-34) 33% had a previous diagnosis with the IRIS infection 39% required hospitalization for IRIS Results No significant differences between the IRIS and nonIRIS groups with regards to age, sex, treatment regimen, CDC disease stage, pre-HAART CD4 count Significant differences: IRIS Non-IRIS P-value Pre-HAART Viral load (log10) 5.52 5.17 0.02 Percent with malnutrition 78% 42% 0.00 Conclusions IRIS is a common occurrence in HIV-infected children starting HAART in Peru Incidence and range of causes was similar to those found in other studies Future studies should examine risk factors so patients more susceptible can be identified and treated promptly