HIV and Immune Reconstitution Inflammatory Syndrome (HIV-IRIS)

The development of antiretroviral therapy (ART) has markedly improved the outlook for patients living with human immunodeficiency virus (PLHIV). However, in a subset of patients, dysregulated immune response after initiation of ART leads to the phenomenon of immune reconstitution inflammatory syndrome (IRIS). A multitude of names have been applied to these situations including immune restoration disease and immune reconstitution inflammatory syndrome (IRIS). HIV- associated IRIS has emerged as an important early complication of ART initiation, associated with considerable morbidity and mortality, particularly in patients who commence ART with advanced immunosuppression. Numerous infective and no infective conditions are associated with IRIS in HIV infection. The commonest forms are associated with mycobacterial infections, fungi and herpes viruses. Timing of ART initiation is critical to reduce IRIS-associated mor¬bidity. Clinicians need to remain vigilant when initiating ART and individualize therapy according to known treatment options for the specific infectious agent.