2. INTRODUCTION
1St description- 1993
Exuberant immune response to existing cerebral infection
HAART therapy
30% in HIV patients
Also in pts on natalizumab after cessation of therapy
3. Forms of IRIS
PARADOXICAL FORM
Restoration of previously suppressed inflammatory response in absence of
cerebral infection.
UNMASKING FORM
Unmasks previously subclinical cerebral infections
4. Risk factors for IRIS
Low CD4 counts
High HIV titer prior to HAART
Rapid fall in CD4 Counts
Initiation of HAART after initiation of opportunistic infections
6. Radiology of IRIS
Enhancing mass
Rapid mass effect
Enhancement - variable, Bizarre, wild
TB- New LN pathy, central necrosis, pul. Nodule, worsening or new abscess
PML- New enhancement or mass effect
Pulmonary Kaposis Sarcoma- reticular or reticulonodular opacities, septal lines ,
plural effusion.
