Immune reconstitution inflammatory syndrome

From IDWiki

Background

  • Two main forms:
    • Unmasking: an underlying, previously undiagnosed infection becomes clinically apparent following immune reconstitution
    • Paradoxical: a diagnosed and treated infection worsens following immune reconstitution

Microbiology

Risk Factors

  • High viral load
  • Low CD4 count

Clinical Manifestations

  • Varies by underlying infection
  • Onset usually a month following starting antiretrovirals, but can be up to a year
    • Mostly within 4 to 8 weeks of starting or changing ART, but with a range from 3 days to several months (or in case reports up to years)

Further Reading

  • Central Nervous System Immune Reconstitution Inflammatory Syndrome. Curr Infect Dis Rep. 2013;15(6). doi: 10.1007/s11908-013-0378-5
    • Provides an overview of CNS-related IRIS syndromes.