American Association of Critical-Care Nurses (AACN) Certification Practice Test

What is Immune Reconstitution Inflammatory Syndrome (IRIS) characterized by?

1. Improvement in immune function without any complications

2. Paradoxical worsening of pre-existing infections or malignancies

3. Immediate immune response within days of ART initiation

4. Reduction in viral load without ART

The correct answer is: Paradoxical worsening of pre-existing infections or malignancies

Immune Reconstitution Inflammatory Syndrome (IRIS) is characterized by a paradoxical worsening of pre-existing infections or malignancies following the initiation of antiretroviral therapy (ART) in individuals with immune suppression, particularly those with HIV/AIDS. As the immune system begins to recover due to the effective treatment of the underlying HIV infection, it becomes more capable of mounting an inflammatory response against previously recognized pathogens or malignancies. This heightened immune response can lead to clinical deterioration, as the body reacts strongly to infections that were previously subdued or asymptomatic. This phenomenon is particularly notable in patients with significant immune recovery, which occurs when the CD4 T-cell counts increase significantly. Although ART improves overall immune function, the inflammatory responses can sometimes lead to complications that exacerbate the clinical condition of the patient, thus allowing for the paradoxical worsening characteristic of IRIS. In contrast, the other options describe scenarios that do not align with the definitions or symptoms of IRIS. For example, statements about improved immune function without complications or immediate immune responses occurring solely within days do not capture the delayed and often complicated nature of IRIS. Similarly, the notion of a reduction in viral load without ART does not pertain to the context of immune reconstitution but rather suggests an