Table 1 Proposed case definitions for antiretroviral-therapy-associated cryptococcosis and unmasking cryptococcal immune reconstitution inflammatory syndrome

Antiretroviral therapy-associated cryptococcosis

1. Patient taking antiretroviral therapy (ART)

2. No recognized cryptococcal disease at ART initiation

3. Clinical disease worsening caused by cryptococcosis occurs after initiation, re-introduction, or regimen switch after previous failure

4. Cryptococcal infection characterized by meningitis, CNS complications, skin or soft-tissue lesions, lymphadenopathy, lung disease, or disseminated disease

Unmasking cryptococcal IRIS

1. Criteria for ART-associated cryptococcosis are met

2. Unusual, exaggerated, or heightened inflammatory manifestations

3. Event occurs early after ART initiation (typically, within 3 months)

4. Failure of ART excluded if possible (eg, ≥1.0 log10 copies/mL decrease in HIV-1 viral load by 8 weeks treatment)