Kaposi Sarcoma-Associated Immune Reconstitution Inflammatory Syndrome (KS-IRIS) in Advanced HIV: Challenges in Managing Visceral Disease With Pericardial Involvement.

Immune reconstitution inflammatory syndrome (IRIS) is a well-described complication following initiation of antiretroviral therapy (ART) in people with HIV. In this case report, we describe the complex clinical presentation of a 27-year-old ART-naïve male with advanced HIV who developed Kaposi sarcoma-associated IRIS (KS-IRIS) with visceral involvement and pericardial effusion shortly after starting ART. We review known risk factors for KS-IRIS, its clinical manifestations including rare cardiac involvement and paradoxical worsening with steroid use, as well as current evidence for chemotherapeutic and antiviral treatment strategies.