Therapeutic Response of HIV-1 Subtype C in African Patients

    Department of Medicine, Fresno VA Hospital, Fresno, California

    The pioneering work of Cassol et al. on the treatment of HIV-1coinfected patients in Africa [1] is to be commended, but some important information seems to have been left out. There was no mention of toxicities or the development of an immune-reconstitution inflammatory syndrome (IRIS) in any of the patients. If IRIS develops in a significant number of patients being treated for HIV-1tuberculosis coinfections, this would have a significant impact on the already limited resources of Africa. Perhaps new ways to diagnose IRIS would have to be developed, rather than the extensive studies done here in the developed world. Since the patients in their study had relatively high CD4+ T cell counts, perhaps no IRIS developed. Could the authors please clarify this

    Reference

    1.  Cassol E, Page T, Mosam A, et al. Therapeutic response of HIV-1 subtype C in African patients coinfected with either Mycobacterium tuberculosis or human herpesvirus-8. J Infect Dis 2005; 191:32432. First citation in article