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- WASHINGTON (Reuters) - Some
AIDS patients whose ravaged immune systems have been boosted by taking
cocktails of powerful medicines have been suffering a surprising increased
susceptibility to infections, researchers said on Monday.
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- Scientists at Thomas Jefferson University in Philadelphia
labeled as a medical paradox their discovery that AIDS patients whose conditions
had been improving thanks to treatment with drug cocktails had been coming
under attack from opportunistic infections that ordinarily should not have
been much of a problem.
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- In a study published in the journal Annals of Internal
Medicine, the researchers said the sometimes-fatal ``immune reconstitution
syndrome'' stemmed from an inflammatory reaction by the newly strengthened
immune system to bacteria or viruses already present in the patient.
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- The researchers said the causes of the syndrome were
unknown.
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- The researchers said they were startled by the fact that
the infections were affecting patients who had been benefiting from so-called
highly active antiretroviral therapy (HAART) involving the use of combinations
of powerful anti-HIV (human immunodeficiency virus) medicines.
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- The doctors described learning of patients with a typical
infection suffered by those with HIV -- mycobacterium avium infection.
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- ``The infection was not showing up in someone with end-stage
AIDS who wasn't taking antiretrovirals and HAART, but someone getting better
and on HAART,'' Thomas Jefferson University's Dr. Joseph DeSimone said
in a statement.
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- DeSimone said some doctors give antibiotics to treat
the opportunistic infections, while others prescribe anti-inflammatory
drugs. Some doctors reduce the HAART treatment.
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- ``No one is exactly sure what to do against this syndrome
yet,'' DeSimone said.
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- The study concluded that it would be difficult to form
controlled studies to find suppressing agents given the ''atypical and
sporadic presentation of these reactions'' considering the number of patients
using drug cocktails.
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- More than a year ago, researchers began to see patients
with HIV, the virus that causes AIDS, developing infections at times that
caught them off guard. The Jefferson doctors said they decided to search
the medical literature and speak with colleagues to learn whether others
had seen similar developments.
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- They said doctors at other hospitals mentioned infections
such as CMV retinitis, an AIDS-related blindness.
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- ``The AIDS-related blindness some patients experience
was getting better, and when patients were started on their HAART therapy
they overall were getting better,'' said Dr. Timothy Babinchak, clinical
director of infectious diseases at Thomas Jefferson University Hospital.
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- ``But then they seemed to be getting an aggravation of
their disease. It was another process, not necessarily the CMV being reactivated.
It was an inflammatory reaction to the CMV infection already there.''
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