Pharm

Immune Reconstitution Inflammatory Syndrome

search

Immune Reconstitution Inflammatory Syndrome

  • Pathophysiology
  1. Onset 2 to 12 weeks after starting Antiretroviral therapy for HIV (onset up to years after starting CART in rare cases)
  2. Recovering Immune System and rising CD4 Counts respond to latent infections and malignancies
  • Findings
  1. Fever
  2. Lymphadenopathy
  3. Symptoms or signs related to underlying infection or malignancy
  • Risk Factors
  1. Low starting CD4 Count
  • Differential Diagnosis
  1. Antiretroviral therapy related Drug Reaction
  • Management
  1. Treat underlying infection or malignancy
  2. Observation and supportive care
  3. Consult with HIV specialist
    1. In unusual cases, Antiretroviral therapy may need to be held
  • References
  1. GoldSchmidt (2016) Am Fam Physician 94(9): 708-16 [PubMed]