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Some HIV patients with very weak immune systems, especially those receiving antiretroviral therapy (ART), experience immune reconstitution inflammatory syndrome (IRIS). Once the immunocompromised patient receives treatment that restores immune system function, the body is capable of recognizing infectious organisms. If an infectious organism is present, it will trigger an inflammatory immune response known as IRIS. Many of the reported IRIS cases in medical literature occurred a few months after ART was initiated. The specific mechanisms involved in the pathogenesis of IRIS are not well understood. However, many experts suggest that IRIS is the result of an enhanced immune response to disease–specific antigens, which subsequently causes an overproduction of inflammatory mediators. IRIS may occur in response to many pathogens. The most common infections associated with IRIS include cryptococcal meningitis, cytomegalovirus infections, mycobacterium avium complex (MAC) infections, tuberculosis (TB) and Pneumocystis jiroveci pneumonia (formerly known as Pneumocystis carinii pneumonia).
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