Immune reconstitution inflammatory syndrome and the central nervous system

This is the authors' abstract. We don't add key points for this paper.

The risk for CNS-IRIS can be decreased by starting ART early in the course of the illness or by reducing antigenic burden with antimicrobial treatment for opportunistic infections prior to starting ART. Of all the forms of CNS-IRIS, the management of IRIS associated with PML due to JC virus infection remains the most challenging, as no antimicrobial drug against this virus is available and the treatment of IRIS requires the use of corticosteroids, which impair the immune cells needed to control the infection.

Management of CNS-IRIS, particularly when associated with PML, is highly challenging due to the conflicting need for corticosteroids which impair necessary immune responses.