Question

What is immune reconstitution syndrome?

16 May 2008. Related: All topics, Living with HIV long-term, Opportunistic infections, South Africa, Starting treatment.

Hi Simon, sorry for asking you another question.

What is immune reconstitution syndrome? Does iit mean that my immune is jumping without control?

Pls I need some clarification.

Answer

Answer: Simon Collins

Immune Reconstitution Syndrome (IRS) mainly affects people who start treatment when their CD4 count is very low (less than 100 cells/mm3 and especially when less than 50 cells/mm3).

Without realising it, you can have infections that your weakened immune system isn’t able to fight. When you start treatment, especially if your CD4 count increases very quickly, this can uncover those infections and they flare up and become active.

So although the HIV treatment is working well against the virus, and your CD4 count is increaing (which is a good thing) you may need to also take new meds to fight the uncovered opportunistic infection.

This can include TB, CMV, MAI/MAC, herpes zoster and other infections etc but usually is not serious in the long-term if treated promptly.

A study from South Africa recently reported that IRS occurred in 25% people who started with low CD4 counts.

It is also called Immune Reconstitution Inflammatory Syndrome (IRIS).

There is a lot of information online about IRIS. For a short overview try this factsheet from AIDSinfonet and for a detailed medical review try this link to the HIV inSite reference manual.