Immune Reconstitution Inflammatory Syndrome (IRIS)—Another New Disease Entity Following Treatment Initiation of HIV Infection

Abstract

After the introduction of highly active antiretroviral therapy (HAART) in 1995 it took 3 years to recognize the new syndrome of lipodystrophy as a long-term complication of HAART [1]. It was found to be a direct toxic consequence of the various drugs used in combination regimens. Another 2 years later, an additional syndrome was described in patients who recently initiated HAART-the immune reconstitution inflammatory syndrome (IRIS) [2-4]. Although already recognized in the pre-HIV era in patients with treatment for tuberculosis [5, 6] and leprosy [7], it became substantially more frequent in HIV-infected patients on HAART. The term IRIS describes a collection of different inflammatory disorders which are associated with paradoxical deterioration of various preexisting infectious processes following commencement of HAART in HIV-infected patients. These preexisting infections in individuals with IRIS may have been previously diagnosed and treated or may have been symptomless and later revealed by the patient's improved capacity to mount an inflammatory response.