Page 37 - Children Bookt.pdf

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A collection of signs and symptoms resulting from the ability to mount
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an immune response associated with immune recovery on ART. 13

10% of all patients initiating ART
Frequency Up to 25% among patients initiating ART with a CD4 cell count
< 50. 14 15

Timing Typically within 2-12 weeks of initiation of ART but may present later

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ART
Signs and
Unmasking of subclinical infections such as TB, which present as new
symptoms
active disease
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Most common
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IRIS events

IRIS may be mild and resolve without treatment.
Continue ART if the patient can tolerate it.
Treat unmasked active OI, such as TB. This may mean temporary
interruption of ART until the patient is stable on TB drugs, then
reintroduction of ART.
Consider other causes for the child’s symptoms, including drug
Management

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where viral hepatitis coinfection is known or suspected.
Prednisone 0.5-1.0 mg/kg/day for 5-10 days is suggested in
moderate to severe cases of IRIS. 17

Notes:
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Typically 2-12 weeks
It does not mean ART is failing
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have started ART and have undergone a reconstitution of their immune responses

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