Table 1.

Common Pathologic IRIS Scenarios

“Unmasking” IRIS

•   Occult, subclinical opportunistic infection

•   Unmasked by ART

•   Infectious pathogens present

“Paradoxical” IRIS

•   Clinical recrudescence of a successfully treated infection

•   Symptomatic relapse despite microbiologic treatment success.

•   Antigen driven immune activation

•   Sterile cultures, typically*

^*Cultures are often negative; however, this depends on the nature of the infection and the timing of the event. Though cultures are negative, histopathology stains, antigen, or DNA based testing is frequently positive.