People suffering from rare disease found

The detection of three cases of rare Immune Reconstitution Inflammatory Syndrome (IRIS) associated with leprosy in Bihar has alarmed the doctors.

Associate professor of skin and VD in the Patna Medical College and Hospital (PMCH) Dr Amar Kant Jha ‘Amar’, who diagnosed the cases in the PMCH, claimed only 12 IRIS patients, including the three in Patna, had been reported in the country so far.

According to him, if a leprosy patient develops AIDS and puts on anti-retroviral treatment (ART), his or her CD4 count improves, but the patient’s leprosy status, which was otherwise dormant, becomes active and full blown.

In IRIS condition, the patients immediately go into a state of leprosy reaction and their legions become more active and virulent. Their nerves become unbearably painful and their general condition sharply deteriorates, which may prove fatal.
Though IRIS was most commonly associated with pneumonia and tuberculosis, its association with leprosy was a rare occurrence, which had been largely aggravated by the augmentation of ART therapy, said Amar.

He said the detection of IRIS in the State had given a big jolt to leprosy and AIDS control programme in Bihar. “AIDS patients are more at risk if they are put on highly active anti-retroviral treatment for the first time, or if they have recently been treated for an opportunistic infection,” he added.

Amar said even though the ART would deteriorate the situation, the therapy must not be discontinued. “Multi-bacillary, multi-drug therapy should be started along with ART to contain the condition,” he prescribed.

The detection of the cases had also made it mandatory that regular examination of HIV-infected individuals should be conducted to detect clinical signs of leprosy, he said.