Lawal, Ismaheel OpeyemiOrunmuyi, Akintunde T.Popoola, Gbenga O.Mokoala, Kgomotso M.G.Lengana, ThaboSathekge, Mike Machaba2022-05-202021-11Lawal, I.O., Orunmuyi, A.T., Popoola, G.O., Mokoala, K.M.G., Lengana, T. & Sathekge, M.M. Immune reconstitution inflammatory syndrome- associated Graves disease in HIV-infected patients: clinical characteristics and response to radioactive iodine therapy. HIV Medicine 2021;22:907–916. https://doi.org/10.1111/hiv.13148.1464-2662 (print)1468-1293 (online)10.1111/hiv.13148https://repository.up.ac.za/handle/2263/85605OBJECTIVES : We aimed to describe the clinical characteristics and the response to radioactive iodine (RAI) treatment of immune reconstitution inflammatory syndrome-associated Graves disease (IRIS-GD) in comparison to Graves disease (GD) seen in HIV-uninfected patients. METHODS : We retrospectively reviewed the medical records of patients treated with RAI for GD. We obtained clinical, biochemical and HIV-related information of patients from their medical records. We compared patient characteristics and response to RAI treatment between patients with IRIS-GD and GD seen in HIV-uninfected patients. RESULTS : A total of 253 GD patients, including 51 patients with IRIS-GD, were included. Among IRIS-GD patients, CD4 cell nadir was 66 cells/µL (range: 37–103) with a peak HIV viral load of 60 900 copies/mL (range: 36 542–64 500). At the time of diagnosis of IRIS-GD, all patients had a completely suppressed HIV viraemia with a CD4 cell count of 729 cells/µL (range: 350–1279). The median interval between the commencement of HIV treatment and the onset of GD was 63 months. At 3 months follow-up, the proportion of patients with IRIS-GD achieving a successful RAI treatment outcome (euthyroid/hypothyroid state) was lower than that of HIV-uninfected patients (35.3% vs. 63.4%, respectively; p < 0.001). The response rate remained lower (60.8%) among patients with IRIS GD than among HIV-uninfected GD patients (80.2%, p = 0.004) at 6 months follow-up. After correcting for differences in age, gender and pre-treatment thyroid-stimulating hormone level, there was no significant difference in RAI treatment response between the two groups. CONCLUSIONS : After correcting for possible confounders, the response to RAI treatment was not different between patients with IRIS-GD and GD in HIV-uninfected patients.en© 2021 British HIV Association. This is the pre-peer reviewed version of the following article : Immune reconstitution inflammatory syndrome- associated Graves disease in HIV-infected patients: clinical characteristics and response to radioactive iodine therapy. HIV Medicine 2021;22:907–916, 2021, doi : 10.1111/hiv.13148. The definite version is available at : http://www.wileyonlinelibrary.com/journal/hiv.Graves diseaseHuman immunodeficiency virus (HIV)Immune reconstitution inflammatory syndrome (IRIS)Radioactive iodine treatmentPostprint Article