IRIS (Immune Reconstitution Inflammatory Syndrome) is primarily treated with steroid medications, such as prednisone, to reduce inflammation while allowing the immune system to recover.
IRIS occurs when people with significantly weakened immune systems, often due to HIV, begin antiretroviral therapy (ART). As the ART works and the immune system starts to recover, it can sometimes overreact to previously existing infections or conditions. This overreaction causes inflammation and can worsen the symptoms of those infections or conditions, leading to IRIS.
Here's a more detailed look at the treatment approach:
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Steroid Medications: Prednisone is a common choice to suppress the excessive inflammatory response associated with IRIS. The dosage and duration of treatment will depend on the severity of the IRIS and the underlying condition.
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Management of Underlying Infections: Any underlying opportunistic infections that triggered the IRIS need to be treated concurrently. This might involve continuing or adjusting antimicrobial therapy for conditions such as:
- Mycobacterium avium complex (MAC)
- Cytomegalovirus (CMV)
- Cryptococcal meningitis
- Pneumocystis pneumonia (PCP)
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Symptom Management: Additional treatments may be needed to manage specific symptoms related to IRIS. For example, pain relievers may be used for pain management, and anti-inflammatory drugs other than steroids may be considered in some cases.
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ART Continuation: It's crucial to continue antiretroviral therapy (ART) unless there are compelling reasons to interrupt it. ART is the foundation for immune reconstitution, and stopping it could worsen the underlying HIV infection. However, in rare and severe cases, temporary interruption of ART may be considered under close medical supervision.
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Monitoring: Close monitoring is essential to assess the effectiveness of treatment and to detect any adverse effects.
It's important to emphasize that the treatment of IRIS is highly individualized and requires careful assessment by a healthcare professional experienced in managing HIV and its complications.
