How is immune reconstitution inflammatory syndrome (IRIS) differentiated from HIV-associated meningitis?

Updated: Aug 24, 2017
  • Author: Gulshan Uppal, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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In patients receiving highly active antiretroviral therapy (HAART) who have a syndrome of relapsing-remitting meningitis with negative cultures and atypical signs and symptoms, consider immune reconstitution inflammatory syndrome (IRIS). This is regarded as an overactive response of a newly reconstituted immune system to infectious agents already present in the patient when the therapy is started.

In IRIS, patients who are on antiretroviral therapy develop symptoms that are consistent with an infectious or inflammatory condition and that cannot be explained by a new or a previous infection or by the side effects of the therapy. It has been proposed that IRIS is due to an imbalance of CD8+/CD4+ cells.

In rare cases, metastatic CNS lymphoma can appear as meningitis.

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