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This is a condition resulting due to initiation of anti-retroviral therapy, whereby the HIV RNA count drops and the immunosuppressive effects are annulled, leading to type-4 hypersensitivity reaction.
There is paradoxical worsening of an existing disease or opportunistic infection or sudden onset of a new clinical symptom. It is particularly common in patients with underlying untreated tuberculosis or fungal infections.
Persistent fever, hepatitis, uveitis, sarcoidosis are some of the major presentations. It is seen in about 10-30% of patients and most common in patients receiving therapy with CD4+ count of <50/microL.
Mithil Jagannath.
Medicowesome 2017.
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