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 unmasking type involves an existing opportunistic infection that only becomes apparent ("unmasked") 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 unmasking IRIS:
(1) The patient experiences the onset of an infectious or inflammatory condition after starting HAART.
(2) The initiation of HAART precedes the clinical deterioration.
(3) The clinical findings are consistent with a pre-existing condition that was not clinically apparent prior to starting HAART.
(4) one or both of the following:
(4a) The onset is within 3 months of starting HAART.
(4b) The findings (clinical, radiologic, histopathologic) are atypical and/or exaggerated.
(5) Exclusion of other explanations for the findings (drug toxicity, newly acquired infection, resistance to HAART, etc).
To read more or access our algorithms and calculators, please log in or register.
