Ramsay Hunt Syndrome during Anti-Retroviral Therapy in an HIV-Seropositive Patient

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  • 治療中にハント症候群を発症したHIV感染症例
  • 臨床 治療中にハント症候群を発症したHIV感染症例
  • リンショウ チリョウ チュウ ニ ハント ショウコウグン オ ハッショウ シタ HIV カンセン ショウレイ

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Abstract

<p>We report the case of an HIV-seropositive patient with Ramsay Hunt syndrome. A 55-year-old bisexual man diagnosed as being HIV-seropositive was started on anti-retroviral therapy (ART), because his CD4+T cell count had decreased to under 200/μL over a period of 2 months. A week after the start of ART, he was diagnosed as having Ramsay Hunt syndrome, based on the presence of herpes zoster oticus and a positive serological test for VZV antibody. We speculate that the facial palsy was associated with the immune reconstitution inflammatory syndrome (IRIS), as follows. The decrease of the CD4+T cell count induced reactivation of VZV in the geniculate ganglion, but facial palsy did not develop. With the reconstitution of the immune system associated with increase of the CD4+T cell count by the ART, the reactivated VZV in the geniculate ganglion elicited an inflammatory response; the associated release of cytokines caused injury to the facial nerve.</p>

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