결핵에 이환된 HIV감염자에서 항레트로바이러스 치료후 발생한 전신적 염증반응 2예

Abstract

Highly active antiretroviral therapy for HIV infection has led to substantial reduction in AIDS associated morbidity and mortality. Systemic inflammatory reactions after the initiation of HAART (highly active antiretroviral therapy) have recently been described in HIV infected patients. The pathogenesis of systemic inflammatory reaction after HAART has not yet been clearly explained, but immune restoration after HAART may explain this phenomenon. We report two cases of systemic inflammatory reactions after starting HAART in HIV-infected patients. In each cases, 5 or 18 days after starting combination antiretroviral therapy, spiking fever and infiltration on chest Xray were developed. The etiology of fever such as opportunistic infection, drug reaction, noncompliance, or malabsorption were evaluated, but cause for clinical deterioration was not found. We concluded that this phenomenon was systemic inflammatory reaction after HAART and we overcame the clinical deterioration by steroid use.