Immune reconstitution inflammatory syndrome (IRIS) is a complication of HIV in which the immune system causes mass inflammation in response to an opportunistic infection. Treatment involves retreating the underlying condition that caused the infection. Antiretroviral drugs can trigger IRIS when virus levels decrease and T-cell levels increase. Symptoms include fever and pain, and the condition can be fatal if the inflammation is in the brain. Treatment involves antibiotics, corticosteroids, and a personalized treatment plan. Recovery is possible with continued antiretroviral therapy.
Immune reconstitution inflammatory syndrome (IRIS) is a complication of HIV in which enhancement of a patient’s immune system causes mass inflammation in response to an already existing opportunistic infection. IRIS occurs when an HIV patient with a compromised immune system begins to respond to antiretroviral drugs. Symptoms come on quickly and can be fatal if the infection involves the brain. Treatment for IRIS involves retreating the underlying condition that caused the infection.
HIV affects the immune system, killing specialized white blood cells known as T cells in order to replicate. With the body no longer able to fight off even simple infections like the cold, most HIV patients succumb to other infections rather than HIV. Drugs known as antiretrovirals slow down the HIV replication process. These drugs can be very successful, holding back the virus and boosting T-cell levels to near normal. It is when virus levels decrease and T-cell levels increase that immune reconstitution inflammatory syndrome can occur.
Before a patient starts antiretroviral treatment, they may already have contracted a viral infection. Because the body cannot produce an immune response, the patient may not experience symptoms. In other cases, the patient had a previously treated infection that continues to persist within the body. When the patient begins antiretroviral treatment, the improving immune system begins to attack the opportunistic infection.
Inflammation is the body’s natural response to infection. Symptoms of immune reconstitution inflammatory syndrome are usually localized. Fever and pain, normal symptoms when a healthy person gets an infection, are greatly intensified when an HIV-infected patient suffers from IRIS. The condition is potentially fatal, especially if the inflammation is in the brain. However, a patient is more likely to experience tissue damage where the inflammation occurs.
Treatment of immune reconstitution inflammatory syndrome requires treatment of the opportunistic infection. You may need antibiotics and other treatments that involve a hospital stay. A course of corticosteroids helps most patients reduce inflammation. Recovery from any disease is complicated when a patient has HIV; doctors monitor a patient’s recovery more closely. A personalized treatment plan is always needed.
If a patient recovers from immune reconstitution inflammatory syndrome, they can continue antiretroviral therapy. The prognosis is generally good if a patient continues his therapy, following all dosing instructions. Any disease a patient contracts after recovery will produce normal symptoms and not an extreme inflammatory response. If IRIS causes tissue damage, additional medical treatment may be required.
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