IRIS: A concern for people
starting HIV therapy

April 2008     View PDF     En español

How do you treat IRIS?

No standard of care is currently in place for treating IRIS, so the best way to treat it is unknown at this time. However, it’s important to address the condition as soon as symptoms appear. Current treatment is based mostly on case reports and other anecdotal data.

Treating IRIS usually starts by treating the active infection, like TB or herpes. HIV therapy is usually continued as well, unless IRIS becomes life-threatening. To reduce the inflammation, you may be prescribed NSAIDs and/or corticosteroids. More research is currently looking at this issue.

Starting HIV therapy while an active infection persists is a controversial issue, and it may be dangerous. However, there are not a lot of data to help guide this type of decision. In fact, several studies show that the closer another infection is diagnosed before starting HIV therapy, the more likely IRIS will occur.

Therefore, deciding to start therapy can be especially troubling for you and your doctor if the infection becomes severe or if your immune system doesn’t respond. Still, if the immune system is stable and other health markers suggest treatment could be successful, holding off on starting HIV therapy may be the best option until the active infection has been resolved.