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Immune Reconstitution Inflammatory Syndrome 

Immune Reconstitution Inflammatory Syndrome
Chapter:
Immune Reconstitution Inflammatory Syndrome
Author(s):

Dagan Coppock

and William R. Short

DOI:
10.1093/med/9780190493097.003.0048
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date: 08 December 2019

Immune reconstitution inflammatory syndrome (IRIS) is associated with either worsening of a recognized infection (paradoxical IRIS) or an unrecognized infection (unmasking IRIS), which occurs in the setting of improved immunologic function. Most patients presenting with IRIS should be maintained on antiretroviral therapy (ART) along with treatment for the associated infection. Screening for latent tuberculosis infection should be undertaken in all HIV-infected patients. In paradoxical IRIS, it is crucial to exclude alternate diagnoses and ensure the patient is receiving appropriate treatment for the condition. In the majority of cases, ART is continued, but on rare occasions cessation of ART is warranted in severe IRIS, particularly when it is life-threatening.

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