Immune reconstitution occurs when a patient's impaired immune system function is restored. For instance, HIV patients have suppressed immune systems that are unable to adequately fight against infections and diseases, making them extremely vulnerable to opportunistic infections (infections that occur in individuals with weakened immune systems). When an infectious organism enters the body of an immunocompromised HIV patient, the inflammatory process is inhibited. Therefore, HIV patients receive antiretroviral therapy (ART), which helps stop the retrovirus from multiplying and subsequently repairs the body's immune system.
Some HIV patients with very weak immune systems, especially those receiving ART, experience immune reconstitution inflammatory syndrome (IRIS). Once the immunocompromised patient receives treatment that restores immune system function, the body is capable of recognizing infectious organisms. If an infectious organism is present, it will trigger an overproduction of inflammatory mediators. This condition is called IRIS.
While immune reconstitution syndrome signals a healthier immune system, it can be a serious and potentially fatal condition. Common infections associated with IRIS include cryptococcal meningitis, cytomegalovirus infections, mycobacterium avium complex (MAC) infections, tuberculosis (TB) and Pneumocystis jiroveci pneumonia (formerly known as Pneumocystis carinii pneumonia).
Researchers estimate that about 20% of patients receiving ART develop IRIS.
Most cases of IRIS resolve in a few weeks with continued HIV treatment. In addition, antibiotics, antifungals or antivirals may be administered to treat OIs, and corticosteroids may be used to suppress the inflammatory process.
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