associated with IRIS include Mycobacterium tuberculosis and cryptococcal meningitis. Persons living with AIDS are more at risk for IRIS if they are starting for the first time, or if they have recently been treated for an opportunistic infection (OI). It is generally advised that when patients have a low initial CD4 T cell count and OI at the time of their HIV diagnosis, they receive treatment to control the OIs before HAART is initiated approximately two weeks later. This is true for most OIs, except for OIs involving the central nervous system. In individuals without HIV/AIDS Since the HIV/AIDS epidemic in the 1980s, IRIS is now mostly associated with the initiation of HIV treatment with highly active antiretroviral therapy (HAART), also referred to as antiretroviral therapy (ART). However, IRIS can still occur in the following conditions that do not involve HIV: Solid organ transplant recipients After undergoing solid organ transplant (liver, kidney, pancreas, etc.), patients are prescribed immunosuppressive agents, such as tacrolimus or cyclosporine. These medications target CD4 immune cells, suppressing their function. IRIS in these patients is thought to be due to the pro-inflammatory response after withdrawal of immunosuppressants. Common infections associated with IRIS in these patients are Cryptococcosis, Cytomegalovirus (CMV), and tuberculosis. Neutropenic patients When the absolute neutrophil count (ANC) is less than 500 per microliter, there is an increased risk of fungal and viral opportunistic infections (OI), such as Aspergillus or CMV. While the patient is immunosuppressed, these infections may remain latent and asymptomatic. However, when the ANC improves, the infections may become symptomatic and present as IRIS. Common infections associated with IRIS in these patients are invasive pulmonary aspergillosis and chronic disseminated candidiasis. Postpartum patients During pregnancy, the immune system is relatively suppressed to prevent fetal rejections or miscarriages. In the immediate postpartum period (3 to 6 weeks), this process is reversed, resulting in a relative pro-inflammatory state. There is an increased risk of IRIS during this period. Common infections associated with IRIS in these patients include cryptococcosis, human papillomavirus reactivation, herpes virus, tuberculosis, leprosy, viral hepatitis. Flare-ups of autoimmune conditions such as systemic lupus erythematosus and rheumatoid arthritis may also occur during this period. Patients on Tumor Necrosis Factor Antagonists Patients with chronic inflammatory conditions (Crohn’s disease, ulcerative colitis, sarcoidosis, etc.) are often treated with TNF antagonists, such as infliximab, adalimumab, and etanercept. Tumor necrosis factors are critical in macrophage activation and subsequent granuloma formation.