Coriorretinitis por Toxoplasma gondii en contexto de un síndrome de reconstitución inmunológica inflamatorio en un paciente con síndrome de inmunodeficiencia adquirida SIDA

Immune reconstitution inflammatory syndrome (IRIS) in context of severe immunosupression secondary to human immunodeficiency virus (HIV), is characterized by a dramatic rise of T lymphocyte CD4+ count in addition to a HIV viral load drop in, typically it is manifested by a paradoxical clinical impairment due to reactivation opportunistic of infectious processes previously under immune surveillance. A 36 years old male with cerebral toxoplasmosis in context of HIV infection developed chorioretinitis 8 weeks after commencing HAART. Workup laboratories only showed a marked T Lymphocyte CD4+ count increase with a HIV viral load lower than 40 copies/ml and other possible causes of chorioretinitis were excluded. After cessation of HAART and establishing corticosteroid therapy clinical improvement of this condition was documented. IRIS incidence has increased among AIDS patients especially with high antigenic burden and very low CD4 + T lymphocyte count. However its mechanism is still unclear due to biomarkers for diagnosis and prognosis are not completely known at all. In order to validate and refine diagnostic criteria and therapeutic approaches of IRIS more studies are needed.