Question

Is a sinus problem IRIS?

6 February 2010. Related: All topics, Side effects, Starting treatment.

I started HIV treatment two weeks ago with a CD4 around 350 and viral load of about 10,000. I am on efavirenz + Truvada. The first night made me very tired but since then I have not really had any side effects.

Two days ago I began to feel like I had a head cold and it has gotten worse.

About a year ago I had what I thought was a sinus infection with congestion and painful sinuses which never seemed to get better.

I am wondering if what I am feeling is serious or will clear up on its own as a result of IRIS. I feel extremely ‘full’ in the head and I feel deaf and I am producing a lot of mucus/catarrh.

Can I expect this to clear up on its own?

My next appointment is in 2 weeks which is my 1 month check up after starting ARV.

I would be grateful for any advice you may have!

Answer

Answer: Simon Collins

Hi

Thanks for your questions.

IRIS (Immune Reconstitution Inflammatory Syndrome) is a term to cover a number of infections that flare up shortly after sharting treatment as your immune system becomes stronger and is now able to recognise and respond to them. This is very unlikely to be responsible, because when you started treatment your CD4 count was still very strong. It usually occurs at CD4 counts below 100 and especially below 50.

Your sinus problems for the last year may have been related to HIV, and if so, may improve now you are on treatment. If not, then you should have this treated, perhaps with antibiotics or allergy meds depending on the cause, and if the symptoms persist, ask to see a specialist.

It is good that you are tolerating treatment well, more information about efavirenz side effects is here.

Your symptoms sounds like flu or a cold, and it is the season for this, but if they continue or get worse, especially any change to your hearing, then please give your doctor a call.

It is important to call your clinic about any symptom as this Q&A service can’t diagnose illnesses. only provide information.