The Approach to the Patient With HIV With Specific Symptom Complexes/Common Presentations

  • Author: Steven C. Johnson, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 10/31/21 (What's New)


  • IRIS can occur with ART use in patients with active opportunistic infections[Shelbourne 2005]
  • IRIS leads to a paradoxical worsening of signs and symptoms of the opportunistic infection
  • Despite the risk of IRIS, clinical trials generally support ART initiation soon after opportunistic infection diagnosis and/or treatment in patients not already on therapy (Management Guidelines)[DHHS Guidelines] Some opportunistic infections present higher mortality risk with IRIS and may require expert consultation regarding the timing of ART, eg, cryptococcal meningitis

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