- Reconstitution of immune system w/initiation of Anti-retroviral therapy→ profound inflammatory reaction as body responds to pathogen(s)/diseases
- Untreated or sub-optimally treated HIV
- Known or quiescent opportunistic infections (OIs)
- Cancer (e.g. Kaposis) or autoimmune d/o
- Transient worsening of known infection/disease or unmasking of quiescent/unknown condition
- Specific sx based on the OI(s)/pathological condition and the anatomic site where focused
- Most commonly assoc w/mycobact, fungal or viral infxns
- E.g: if pulmonary TB—>worsening sob and hypoxia
- If CNS crypto→ worsening meningitis/head ache
- If cmv retinitis→ worsening vision
- Sx range from mild to severe
- Occurs within days to ~8 weeks of starting ARVs (typically w/in 3w)
- Then sx resolve & patient improves.