Management of IRIS

Clinical description

• Confirm that ART is actually taken as prescribed.
• Continue ART if ART toxicity has been ruled out as the underlying cause.
• Treat the OI.
• Remember that in case of any CNS infections (e.g., cryptococcal and TB meningitis cerebral

toxoplasmosis) ART should be started 5 weeks after initiating treatment of CNS infection.

• Consider TB treatment failure if worsening occurs after more than one month on TB treatment.
• Admit severe cases to hospital.
• NSAIDs may be given in mild and moderate cases. Consider prednisolone (e.g., 1mg/kg for 2 weeks

then 0.5mg/kg for 2weeks) only in severe IRIS.

Differentiated ART services