Aseptic meningitis and acute HIV syndrome after interruption of antiretroviral therapy

Viral Rebound Syndrome in Two HIV-1–Positive Patients after Structured Treatment Interruption

“…The common symptoms were high grade fever, malaise, fatigue, headache and lack of appetite. There was no rash or aseptic meningitis as reported previously by Worthington et al (9) and Colven et al (2) Only in one case slightly enlarged peripheral lymph nodes were observed. The same symptoms could occur in many bacterial, fungal and viral diseases.…”

“…It affects some of HIV positive individuals with previous viral suppression and then viral rebound (2)(3)(4)6,9). The reason of STI in our patients was to decrease total exposure to antiretroviral drugs because of the development of lipodystrophy and lipoatrophy due to ART (8).…”

“…There are a few reports on viral rebound syndrome, which may occur after cessation of potent HAART in individuals with chronic HIV infection (2,3,6,9). The symptoms resemble those observed in acute retroviral disease (ARD) and are due to a rebound in plasma HIV RNA (2)(3)(4)6,9).…”

“…The symptoms resemble those observed in acute retroviral disease (ARD) and are due to a rebound in plasma HIV RNA (2)(3)(4)6,9). Considering toxicity, drug resistance, as well as other factors, when efficient ART is interrupted, structured treatment interruption (STI), although not officially recommended, seems to be a treatment option (5,7).…”

Cerebrospinal Fluid HIV Escape from Antiretroviral Therapy

“…MRI of these cases may show focal, contrast-enhancing, T2 hyperintense and T1 hypointense subcortical lesions [48, 58••], and meningeal thickening with contrast enhancement in T1-weighted sequences [58••, 62]. Some of these cases may remind of the acute meningoencephalitis cases observed during primary infection or in the context of the acute retroviral rebound syndrome following ART interruption [23,67]. Table 2 summarizes some of the main laboratory features of this disorder, drawing on previous reports.…”