Immune reconstitution inflammatory syndrome is an immune system response that causes an infectious disease. It is most common in people who are receiving treatment for HIV. It occurs within the first 6 months of treatment.

Most cases of IRIS are resolved quickly. Severe cases can be fatal without treatment. IRIS is treated with continued therapy and treatment of the infection. Steroids may be needed in very severe cases.

Immune reconstitution inflammatory syndrome (IRIS) is a condition that sometimes affects people living with HIV who take antiretroviral therapy (ART) medication.

“The immune system is activated when ART medication is used. The immune system can cause an inflammatory response if it is improved. The responses are usually to a pathogen that is present in the body but isn’t causing any symptoms before ART treatment, but it could also develop from a new infection.”

Pathogens associated with IRIS include:

IRIS often resolves quickly. However, IRIS that activates a serious underlying infection can be fatal without treatment.

If you are taking ART medication, you should keep your doctor informed of any new symptoms that occur.

IRIS is an immune system response to ART. It’s most common in people with HIV who are just beginning treatment, whose immune systems have been weakened by the virus.

The weakened immune system allows infections to remain in the body. In some cases, infections were treated and symptoms were resolved. In other cases, the infections never caused any symptoms and were never diagnosed.

ART medication strengthens the immune system. The immune system can be over-responding to these infections. This leads to inflammation and symptoms of the infection.

IRIS most often occurs within the first 6 months of ART treatment.

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The symptoms of IRIS in people with HIV are dependent on the underlying infections.

Mild or severe symptoms can occur. Some people with IRIS have no symptoms at all.

The biggest sign of IRIS is an overactive inflammatory response. Symptoms of common underlying infections are discussed below.

People with underlying Tuberculosis can have symptoms.

People with underlying pneumonia can have symptoms.

People with underlying hepatitis have some symptoms.

Mild cases of IRIS can sometimes resolve on their own because ART helps boost the immune system.

The standard treatment for the underlying infections is the most effective way to cure IRIS.

The underlying infection could be treated with medication.

People with moderate to severe IRIS who are experiencing painful or disruptive symptoms might also receive treatments for those symptoms. This can include:

Most cases of IRIS are mild and resolve quickly without lasting effects. Severe cases can cause serious symptoms and can be fatal.

Infections that affect the brain or nervous system are considered to be especially dangerous.

People with IRIS continue to take ART despite the side effects. The immune system can recover from HIV damage. The immune system can fight the underlying infections that are causing IRIS.

Living with HIV

HIV can be a challenge to live with. It is important to have support when you are managing your condition. Consider using these great resources for support.

  • The Well Project: The Well Project offers supportive resources and forums where women and girls with HIV can connect and find support.
  • POZ Community Forums: POZ Community Forums are discussion boards for people with HIV to share stories, tips, support, and more.
  • Positive Peers: You can use your smartphone app to access Positive Peers, a supportive group for people between ages 13 and 34 who have HIV.
  • Thrive SS: Black gay or bisexual men can connect with Thrive SS to find local peer support groups and mental health resources.
  • Housing Opportunities for Persons With AIDS (HOPWA): People with HIV and their families can secure housing through the federal Housing Opportunities for Persons With AIDS (HOPWA) program.
  • Ryan White HIV/AIDS Program: People who meet income requirements can get financial assistance through the Ryan White HIV/AIDs program.

During the first few months of ART treatment for HIV, the immune system can respond to the drug.

IRIS causes an old infection to be reactivated and causes new symptoms. The symptoms of IRIS are dependent on the underlying infections.

Some cases of IRIS do not cause symptoms. Mild, moderate, or severe symptoms can be present when they are present.

In many cases, IRIS is mild and resolves quickly without any complications. Severe cases can be fatal if left untreated. Make sure to talk with your doctor if any new symptoms develop during your HIV treatment.