Infectious Disease Compendium

Immune Reconstitution Syndrome (IRIS)

Microbiology

Variable.

Epidemiologic Risks

As HIV patients take their HAART for the first time, they get a rebound in their CD4 counts and can become symptomatic for a variety of infections that were there, but asymptomatic due to the lack an inflammatory response.

Non HIV patients who can get IRIS: recovering neutropenics with hepatosplenic candida (PubMed) and aspergillus and post partum (PubMed). In neutropenics with aspergillus, IRIS is a good prognostic sign.

IRIS can also occur in transplant patients with exacerbations fungi of all types, M. tuberculosis, cytomegalovirus, and polyoma virus nephropathy.

Syndromes

Cytomegalovirus and Pneumocystis lead the list, but any of the standard HIV opportunistic infections can become symptomatic.

As part of IRIS, HIV patient can get a CD8 encephalitis (PubMed) that is treated with steroids.

Treatment

Per the infecting organism.

Notes