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
- Mycobacteria
- Fungi
- Viruses
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.