Patient selection: HIV patient receiving HAART (highly active antiretroviral therapy)
Major criteria:
(1) decrease in HIV viral load in copies per mL blood by more than 1 LOG10
(2) an atypical presentation of an opportunistic infection or tumor with all of the following:
(2a) localized disease
(2b) exaggerated clinical inflammatory reaction (fever, pain, etc)
(2c) atypical histologic inflammatory response
(2d) progression (organ dysfunction, enlargement, etc) of a pre-existing disease after definite clinical improvement with pathogen-specific therapy prior to HAART
(2e) exclusion of treatment toxicity and new diagnosis
Minor criteria:
(1) increase in the CD4-positive lymphocyte count
(2) increase in the immune response to the pathogen involved
(3) spontaneous resolution of the disorder with continued ART and without additional therapy
Diagnosis of IRIS can be made with:
(1) both major criteria
(2) (one major criterion) AND (2 or 3 minor criteria)
