inPractice® - ART Initiation and IRIS in Patients With Cryptococcosis

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]}