Management of IRIS
Summary
- Early ART initiation has been associated with increased risk of cryptococcal IRIS in several studies,[Boulware 2014; Bisson 2013; Shelburne 2005; Lortholary 2005] although others have not observed this relationship[Sungkanuparph 2009; Bicanic 2009; Grant 2010; Boulware 2014]
- Mortality was significantly higher with early vs deferred ART initiation in the COAT study even though IRIS incidence was not significantly different between the 2 groups[Boulware 2014]
- Cryptococcal IRIS is frequently fatal in settings where aggressive management of elevated intracranial pressure is not available[Meya 2010]
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Keywords: Cryptococcus, Initial Antiretroviral Therapy, IRIS