Immune Restoration Syndrome and Cryptococcosis Associated with Kaposi's Disease at Brazzaville University Hospital, About A Case Plus Review of the Literature

Immune Restoration Syndrome (IRIS) is a frequent phenomenon in profoundly immunocompromised individuals who are late starters on highly active antiretroviral therapy. It is often under-notified due to a lack of available technical resources in resource-limited countries, where viral load and TCD4 lymphocyte cell assays are not always available. In tropical Africa, the active search for opportunistic infections prior to initiation of ART has not yet become part of the practice of some doctors, and some patients find their health situation exacerbated sometime after the start of treatment. Immune restoration pathologies include neuromeningeal cryptococcosis (CNM) and Kaposi's disease, which classify patients as WHO stage 4. Diagnosis of immune restoration is clinically suspected, while confirmation is immuno-virological, with a significant increase in TCD4 cell counts and a critical reduction in viral load at an early stage. The association of Cryptococcosis and Kaposi's disease testifies to advanced immunodepression in people who start antiretroviral treatment late, as was the case in the present study.