Cerebrospinal fluid contribution in the diagnosis of immune reconstitution inflammatory syndrome associated with cryptococcal meningitis

Objective: Identify cases of Immune Reconstitution Inflammatory Syndrome (IRIS) associated with cryptococcal meningitiswich is defined as a clinical deterioration attributed to the recovery of the immune system during the use of antiretroviral drugs (ART) in patients infected with Human Immunodeficiency Virus (HIV)and show the inflammatory reaction that occurs in the cerebrospinal fluid (CSF). Methods: A retrospective study based on medical records of 266 HIV seropositive patients treated at Hospital de Base, São José do Rio Preto, in the period from January 1996 to December 2012 with a diagnosis of cryptococcal meningitis. The criteria of the "International Network for the study of HIV -associated IRIS" (INSHI) for case definitions were used. Results and Discussion: 124 patients received ART medication. 27(21.8 %) cases of IRIS were identified. Of the 27 patients with IRIS, 23 (85.2 %) were classified as IRIS-D and4 (14.8 %).The cytological and biochemical analysis of the CF collaborates for the diagnostic screening of IRIS associated with CM, with subsequent association with the criteria of the INSHI. Conclusions: Most patients with SIRI showed an inflammatory reaction and increase of leukocytes in the CSF. The inflammatory reaction occurs in the CSF, especially with increased leukocyte and protein. IRIS remains a presumptive diagnosis.