Immune Reconstitution Inflammatory Syndrome and Cytomegalovirus Pneumonia Case Report: Highlights and Missing Links in Classification Criteria and Standardized Treatment
Table 1
Proposed criteria for the classification of IRIS patients, French et al. (2004) [13].
Major criteria
Minor criteria
Exclusion criteria
(A) Atypical presentation of opportunistic infection or tumors in patient responding to ART (B) Decrease in plasma HIV RNA level > 1 log 10 copies/ml
Increase in CD4+ T-cell count after ART Increase in immune response specific to relevant pathogen Spontaneous resolution of disease with no specific antimicrobial therapy or tumor chemotherapy while continuing ART
Failure of treatment to OIs because of microbial drug resistance Poor adherence to treatment for OI/absorption problems Presence of other OIs or neoplasm, drug toxicity, or reaction
For IRIS diagnosis patients must meet 2 major criteria (A + B) or one major criterion (A or B) plus 2 minor criteria (1, 2, or 3), without the presence of exclusion criteria, IRIS immune reconstitution inflammatory syndrome, ART antiretroviral therapy, OIs opportunistic infections, and HIV human immunodeficiency virus.