Is acute appendicitis another inflammatory condition associated with highly active antiretroviral therapy (HAART)?

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Abstract
1Department of Genitourinary Medicine, St George's Hospital, London, UK, 2Department of Infectious Diseases, Cork University Hospital, Cork, Ireland, 3Department of Infectious Diseases and 4Department of Histopathology, St George's Hospital, London, UK Objective To report the occurrence of acute appendicitis as a possible manifestation of the immune restoration inflammatory syndrome (IRIS) following the commencement of highly active antiretroviral therapy (HAART) in HIV patients. Design Case-note review of HIV patients on HAART with acute appendicitis. Methods Review of HIV markers, antiretroviral therapy and abdominal ultrasound results of four HIV patients with acute appendicitis and the histopathology reports on the appendix in two of the patients. Results From a population of approximately 350 HIV patients on HAART, we found four patients who developed acute appendicitis within 6 months of commencing or changing HAART. Conclusion Acute appendicitis occurring in HIV patients on HAART may represent a variant of IRIS. Further immunohistopathological and epidemiological evaluation will be needed to define this relationship fully.