Highly active antiretroviral therapy-induced immune recovery in an HIV-positive patient with a history of herpes zoster ophthalmicus

Pagani, Jean Marie; Duan, Jennifer Qian

doi:10.1016/j.optm.2010.07.030

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…A potential candidate herpesvirus is VZV. VZV can cause direct damage of CNS vessels of all calibres and indirect damage of CNS cells [16] and it is a well known cause of CNS vasculitis and ocular infections in HIV-infected subjects [17,18]. In addition, herpes zoster, resulting from peripheral VZV reactivation, is a frequent IRIS manifestation and cases of VZV CNS-IRIS have recently been reported [19,20].…”

Section: Discussionmentioning

confidence: 99%

Susac’s syndrome as HIV-associated immune reconstitution inflammatory syndrome

et al. 2013

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Susac’s Syndrome (SS) is an autoimmune endotheliopathy of cerebral, retinal and cochlear arterioles. We report of an HIV-infected woman who developed a first SS episode following a spontaneous reduction of plasma viral load and several relapses six years later, following initiation of combined antiretroviral therapy (cART). Corticosteroids and intravenous immunoglobulins alone did not control the disease, which improved after combined treatment with acyclovir and ganciclovir. SS onset in HIV infection and relapses during cART-induced immune reconstitution are consistent with the dysimmune nature of the disease. The response to anti-herpes drugs suggests a viral contribute in this case of SS.

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Section: Discussionmentioning

confidence: 99%

Susac’s syndrome as HIV-associated immune reconstitution inflammatory syndrome

et al. 2013

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“…15 An HIV-infected individual may experience ocular inflammation subsequent to HAART initiation as a result of Immune Reconstitution Inflammatory Syndrome (IRIS). 16 However the incidence of ocular complications of HIV infection has decreased particularly in the developed countries because of the use of HAART. 6 In the pre-HAART era, the prevalence of HIV-related ocular manifestations was higher than post-HAART era.…”

Section: Discussionmentioning

confidence: 99%

Orbital Apex Syndrome: a rare complication of herpes zoster ophthalmicus in a Ghanaian woman living with HIV

EsAyisi-Boateng

Ayisi-Boateng

Amoah

et al. 2021

gmj

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Herpes Zoster Ophthalmicus (HZO) usually affects the immunocompromised and aged. It results from the reactivation of latent varicella zoster infection in the trigeminal ganglia. Orbital apex syndrome (OAS) is a rare sequela of the disease and tends to be disfiguring and vision-threatening if not addressed. We report on a 43-year-old Ghanaian female living with Human Immunodeficiency Virus infection and on highly active antiretroviral therapy who presentedwith a 2-month history of a healed vesicular rash left side of the forehead and a droopy left upper eyelid. On examination, she had complete ptosis, visual acuity in the left eye was 6/36, and restricted mobility in all directions of gaze. On anterior segment examination using a slit lamp biomicroscope, the left eye had mild cornea oedema with keratic precipitates and relative afferent pupillary defect (RAPD). Intraocular pressure and posterior segment of the right eye were normal. Computed tomography (CT) Scan of the head was taken to rule out other causes of OAS. Patient was treated with oral acyclovir 400mg five times daily for 30 days, topical steroids and oral prednisolone 60mg daily for 30 days which was tapered. Ptosis improved significantly with mild supraduction and infraduction deficit. Visual acuity improved to 6/12 and all keratic precipitates cleared. The patient, however, developed a corneal scar from a possible neurotrophic ulcer after defaulting treatment for 11 months. OAS , as a rare sequalae of HZO, responds well to oral acyclovir and steroids. Prompt diagnosis and appropriate treatment, even at late presentation, yield positive outcomes.

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“…Several cases of herpes-associated CNS-IRIS have been successfully resolved through the use of acyclovir or ganciclovir [20,21]. CNS-IRIS events associated with varicella zoster virus (VZV), cytomegalovirus (CMV), herpes simplex viruses (HSV) and Epstein-Barr virus (EBV) have diverse presentations such as cerebral vasculitis, ophthalmicus, retinitis, cerebral infarcts, optic chiasm inflammation and vision loss as well as encephalitis and stroke [22,23].…”

Section: Key Pointsmentioning

confidence: 99%

Immune reconstitution inflammatory syndrome and the central nervous system

Johnson

Nath

2011

Current Opinion in Neurology

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The risk for CNS-IRIS can be decreased by starting ART early in the course of the illness or by reducing antigenic burden with antimicrobial treatment for opportunistic infections prior to starting ART. Of all the forms of CNS-IRIS, the management of IRIS associated with PML due to JC virus infection remains the most challenging, as no antimicrobial drug against this virus is available and the treatment of IRIS requires the use of corticosteroids, which impair the immune cells needed to control the infection.

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Highly active antiretroviral therapy-induced immune recovery in an HIV-positive patient with a history of herpes zoster ophthalmicus

Cited by 4 publications

References 35 publications

Susac’s syndrome as HIV-associated immune reconstitution inflammatory syndrome

Susac’s syndrome as HIV-associated immune reconstitution inflammatory syndrome

Orbital Apex Syndrome: a rare complication of herpes zoster ophthalmicus in a Ghanaian woman living with HIV

Immune reconstitution inflammatory syndrome and the central nervous system

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