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The risk factors associated with the development of IRIS are poorly understood. It appears that the risk is higher if ART is initiated soon after treatment for opportunistic infection (OI) is started. It also appears that patients who experience a sharp rise in CD4 cell counts in the early weeks or months after initiation of ART have an increased risk of developing IRIS. However, the optimal timing of ART initiation in relation to OI treatment remains unclear because there are several factors to consider. For instance, the type of pathogen that induced the OI, the severity of the OI, the type of medication used to treat the OI and potential risk for drug toxicity or interactions should be taken into consideration.
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