Aggressive worsening of Sézary syndrome during early antiretroviral therapy

摘要

Sezary syndrome is an aggressive leukemic variant of cutaneous T-cell lymphoma characterized by a monoclonal proliferation of CD4~+/CD45R0~+ T cells [1]. In HIV-infected persons, reconstituting immunity after highly active antiretroviral therapy (HAART) initiation can cause complications, notably immune reconstitution inflammatory syndrome (IRIS). IRIS results from rapid restoration of antigen-specific immune responses [2]. We report a case of aggressive worsening of Sezary syndrome in the context of early HAART that we consider to be related to alterations in the dynamics of CD4~+ T-cell numbers and function induced by HAART, but not a case of IRIS.