Immune reconstitution inflammatory syndrome information
Medical condition
Immune reconstitution inflammatory syndrome
Specialty
Immunology
Immune reconstitution inflammatory syndrome (IRIS) is a condition seen in some cases of HIV/AIDS or immunosuppression, in which the immune system begins to recover, but then responds to a previously acquired opportunistic infection with an overwhelming inflammatory response that paradoxically makes the symptoms of infection worse.[1]
IRIS may also be referred to as immune reconstitution syndrome, immune reconstitution disease, immune recovery disease, and immune restoration disease.[2]
Systemic or local inflammatory responses may occur with improvement in immune function. While this inflammatory reaction is usually self-limited, there is risk of long-term symptoms and death, particularly when the central nervous system is involved.[3][4]
Management generally involves symptom control and treatment of the underlying infection. In severe cases of IRIS, corticosteroids are commonly used. Important exceptions to using corticosteroids include Cryptococcal meningitis and Kaposi’s sarcoma, as they have been associated with poorer outcomes.[3][4]
^Shelburne SA, Visnegarwala F, Darcourt J, Graviss EA, Giordano TP, White AC, Hamill RJ (March 2005). "Incidence and risk factors for immune reconstitution inflammatory syndrome during highly active antiretroviral therapy". AIDS. 19 (4): 399–406. doi:10.1097/01.aids.0000161769.06158.8a. PMID 15750393. S2CID 2062992.
^Wolfe C (2023). Post TW (ed.). Immune reconstitution inflammatory syndrome. Waltham, MA: UpToDate.
^ abThapa S, Shrestha U (2022). "Immune Reconstitution Inflammatory Syndrome". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 33620872. Retrieved 2023-02-09.
^ abBrust JC, McGowan JP, Fine SM, Merrick ST, Radix AE, Vail RM, et al. (2021). Management of Immune Reconstitution Inflammatory Syndrome (IRIS). New York State Department of Health AIDS Institute Clinical Guidelines. Baltimore (MD): Johns Hopkins University. PMID 34029021.
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