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Type I lepra reaction presenting as immune reconstitution inflammatory syndrome
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2007
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VasculitisImmunologyPathologyHuman Immunodeficiency VirusImmunotherapyInflammationType 1Reaction PresentingPrimary ImmunodeficiencyRheumatologyAutoimmune DiseaseAutoimmunityImmunologic DiseaseChronic Viral InfectionHivAntiretroviral TherapyInborn Error Of ImmunityAids PathogenesisPathogenesisImmunosuppressionMedicine
Immune reconstitution inflammatory syndrome (IRIS) is an unusual inflammatory reaction due to infectious and non-infectious causes occurring in human Immunodeficiency virus (HIV)-infected patients. IRIS occurs after the initiation of antiretroviral therapy. There are no reports of type I lepra reaction due to IRIS in published literature from India. We report two cases of HIV-infected males who presented with borderline tuberculoid leprosy in type 1 reaction after the initiation of highly active antiretroviral treatment (HAART). Case 1 presented with multiple, tender, erythematous and hypoesthetic plaques on the trunk and extremities after 3 months of antiretroviral therapy. In case 2, type I lepra reaction was observed 2 months after the initiation of HAART.