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Criteria of Haddow et al for the Paradoxical Type of the Immune Reconstitution Inflammatory Syndrome (IRIS)

Description

Haddow et al distinguish 2 types of the immune reconstitution inflammatory syndrome (IRIS) that may affect an HIV-infected patient treated with highly-active antiretroviral therapy (HAART). The paradoxical type involves an existing opportunistic infection that behaves in an atypical or exaggerated way after starting HAART. The authors are from King's College London, University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital in Durban, South Africa.


 

Criteria for paradoxical IRIS:

(1) The patient experiences a deterioration in an infectious or inflammatory condition after starting HAART.

(2) The condition was clinically apparent prior to starting HAART.

(3) one of the following:

(3a) There is deterioration in a condition that was well-controlled prior to HAART.

(3b) The findings (clinical, radiologic, histopathologic) have become atypical and/or exaggerated.

(3c) For an episodic condition, the findings are severe and/or difficult to control compared to episodes prior to starting HAART.

(4) Exclusion of other explanations for the findings (drug toxicity, newly acquired infection, resistance to HAART, etc).

 


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Specialty

ICD-10