European Journal of Medical Research - Deutsche AIDS ...

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June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH 61 out HAART had pruritus (38%) and 18 dry skin (40,9%). IgE was elevated in 43 patients, 8 of those had a CD4 cell count
62 EUROPEAN JOURNAL OF MEDICAL RESEARCH June 27, 2007 to immune reconstitution frequently presenting with atypical clinical signs and symptoms. Results: A 62 year old HIV-infected patient reported development of a focal swelling of the dorsum of the left hand resembling lipomatosis 2 weeks after switching to an antiretroviral therapy regimen consisting of AZT, 3TC, and lopinavir. At that time CD4 cell count was 247/l and viral load below the limit of detection. Four months later therapy was changed to liponavir monotherapy because of toxicity (anemia) and further two months later the patient realised a similar swelling of the dorsum of his right hand with progress over two months. The tumor of the left hand was then diagnosed as tenosynovitis based on magnet resonance tomography (MRT) revealing a non-infiltrating fluidlike process with a size of 7x16x25 mm and peripheral vascularisation consistant with an inflammatory process. He complained about no pain or other signs and symptoms. He had been on different combination therapies including non-nucleoside and nucleoside analogue reverse transcriptase inhibitors for three years with good immunological response (CD4 cells 8/l, > 750.000 copies HIV-RNA copies/ml plasma before therapy). He had never had lipomas before in his live nor did any of his familiy members. After initiation of lopinavir therapy increase of C-reactive protein (CRP) to 46.9 mg/l was observed. Because of the close time relation of the hand swelling and start of lopinavir treatment, the therapy was switch to atazanavir 300mg QD, ritonavir 100mg BID, and saquinavir 500mg BID. This was followed by immediate and complete disappearance of the left and significant reduction of the right dorsal hand lipomas within a few weeks. Six weeks after the last therapy switch CRP had declined to 27.3 mg/l. Conclusion: Tenosynovitis associated with protease inhibitor therapy can be misdiagnosed as lipomatosis. Whether this patient suffered from either immune reconstitution syndrome or rather drug related toxicity remains unclear. Replacement of lopinavir led to complete clinical resolution and drop of inflammatory parameters. B.26 (Vortrag) Untreated HIV patients with undetectable virus – What happens to the CD4 cells? Eger J. 1 , Wolf E. 2 , Gölz J. 3 , Brust J. 4 , Ulmer A. 5 , Nzimegne-Gölz S. 3 , Mosthaf F. 6 , Vogel M. 7 , Rockstroh J. 7 , Leistner I. 8 , Mayr C. 8 , Carganico A. 9 , Mueller M. 5 , Jäger H. 1 , NoVi Study Group 1 HIV Research and Clinical Care Centre Munich, Munich, Germany, 2 MUC Research, Munich, Germany, 3 HIV Outpatient Practice Kaiserdamm, Berlin, Germany, 4 Private Practice for Internal Medicine, Hematology and Oncology, Mannheim, Germany, 5 HIV Outpatient Practice, Stuttgart, Germany, 6 Private Practice for Hematology, Oncology and Infectious Diseases, Karlsruhe, Germany, 7 University Hospital of Bonn, Bonn, Germany, 8 Ärzteforum Seestraße, Berlin, Germany, 9 HIV Outpatient Practice, Berlin, Germany Background: To evaluate whether low level viral replication in untreated HIV-1 patients will persistently prevent immunological deterioration and disease progression. Methods: Ongoing multi-centre cohort study in untreated HIV-1 patients with low virus replication. Entry criteria were a persistent viral load (VL) level 600/l to
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