Immune reconstitution inflammatory syndrome: Difference between revisions
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*Also called IRIS | *Also called IRIS | ||
*Definition-Disease or pathogen specific inflammatory response in HIV infected patients after initiation or re-initiation of ARV therapy or after change to more active ARV therapy. | *Definition-Disease or pathogen specific inflammatory response in HIV infected patients after initiation or re-initiation of ARV therapy or after change to more active ARV therapy. | ||
*Usually low CD4 counts and high viral loads at time of ARV initiation | |||
*Can occur at any CD4 count | |||
*Occurs usually within 4-8 weeks after initiation of therapy | |||
==Clinical Features== | ==Clinical Features== | ||
===Major Presentations=== | |||
*TB- worsening TB symptoms | |||
*MAC- localized lymphadenitis, pulm disease, systemic inflammation indistinguishable from active MAC | |||
**MAC-IRIS patients are not bacteremic | |||
*Crypto- worsening meningitis symptoms | |||
*CMV-Retinitis, Vitritis, Uveitis | |||
**IRIS due to CMV can cause vision loss | |||
***mean time to vitritis 20 weeks | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 17:23, 31 July 2015
Background
- Also called IRIS
- Definition-Disease or pathogen specific inflammatory response in HIV infected patients after initiation or re-initiation of ARV therapy or after change to more active ARV therapy.
- Usually low CD4 counts and high viral loads at time of ARV initiation
- Can occur at any CD4 count
- Occurs usually within 4-8 weeks after initiation of therapy
Clinical Features
Major Presentations
- TB- worsening TB symptoms
- MAC- localized lymphadenitis, pulm disease, systemic inflammation indistinguishable from active MAC
- MAC-IRIS patients are not bacteremic
- Crypto- worsening meningitis symptoms
- CMV-Retinitis, Vitritis, Uveitis
- IRIS due to CMV can cause vision loss
- mean time to vitritis 20 weeks
- IRIS due to CMV can cause vision loss