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

From: Cryptococcal meningitis and immune reconstitution inflammatory syndrome in a pediatric patient with HIV after switching to second line antiretroviral therapy: a case report

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)
  1. Above proposed definitions taken from Haddow et al. Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions. Lancet Infect Dis 2010;10(11):791–802