TY - CHAP M1 - Book, Section TI - Immune Reconstitution Inflammatory Syndrome (IRIS) A1 - Raffanti, Stephen P. A1 - Person, Anna K. A2 - Knoop, Kevin J. A2 - Stack, Lawrence B. A2 - Storrow, Alan B. A2 - Thurman, R. Jason Y1 - 2021 N1 - T2 - The Atlas of Emergency Medicine, 5e AB - Effective antiretroviral therapy (ART) for HIV establishes virologic suppression and can allow the patient’s immune system to rebuild to a near-normal competency. In some patients who develop a rapid immune response following ART initiation after a very advanced degree of immune suppression, the immune reconstitution inflammatory syndrome (IRIS) can develop. In these patients, it is thought that previously subclinical infections manifest with the development of a more robust immune status. IRIS is most often seen in patients who have recently started ART (usually within 60 days of starting therapy) with an initial CD4 count below 100 cells/mm3. The most common infections that can “trigger” IRIS include Mycobacterium (tuberculosis and Mycobacterium avium complex [MAC]), cytomegalovirus (CMV), cryptococcal disease, and histoplasmosis. Patients typically present with fever, malaise, lymphadenopathy, and symptoms associated with the active opportunistic infection. SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1181057323 ER -