{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:07:35Z","timestamp":1789031255399,"version":"build-2803163510"},"reference-count":13,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Immune reconstitution inflammatory syndrome (IRIS) is a recognized complication of antiretroviral therapy (ART) in people living with HIV, typically presenting as a single opportunistic infection. Concurrent multisystem IRIS, particularly during the puerperium, is extremely rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We report a 27-year-old woman newly diagnosed with HIV during the third trimester of pregnancy who initiated dolutegravir-based ART at 35 weeks\u2019 gestation. Three months postpartum, she developed multiple concurrent IRIS manifestations, including oral candidiasis, Kaposi\u2019s sarcoma, severe thrombocytopenia, severe anemia, pulmonary embolism, viral pneumonitis, cholangitis, and peripartum cardiomyopathy. Published literature identified very few cases of three or more simultaneous IRIS events after ART initiation, with no previous reports describing such extensive multisystem involvement in the puerperium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This appears to be the first reported puerperal case of extensive multisystem IRIS. We propose the term\n                      <jats:bold>\u201cIRIS multiplex\u201d<\/jats:bold>\n                      to describe patients presenting with five or more concurrent IRIS manifestations, as a hypothesis-generating concept for future research.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259582261488586","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:23:53Z","timestamp":1788895433000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["First Reported Case of Puerperal Immune Reconstitution Inflammatory Syndrome With Multiple Systemic Manifestations in an HIV-Positive Woman: A Case Report and Structured Literature Review"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8791-7222","authenticated-orcid":false,"given":"Christine","family":"Katusiime","sequence":"first","affiliation":[{"name":"Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morris K.","family":"Rutakingirwa","sequence":"additional","affiliation":[{"name":"Makerere University"},{"name":"Makerere University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.939210"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S476922"},{"issue":"9","key":"e_1_3_7_4_2","first-page":"1547","article-title":"A patient with multiple Immune Reconstitution Inflammatory Syndrome (IRIS) following initiation of antiretroviral therapy","volume":"6","author":"Achappa B","year":"2012","unstructured":"Achappa B, Madi D, Shetty N, Mahalingam S. A patient with multiple Immune Reconstitution Inflammatory Syndrome (IRIS) following initiation of antiretroviral therapy. J Clin Diagn Res. 2012;6(9):1547-1549.","journal-title":"J Clin Diagn Res"},{"key":"e_1_3_7_5_2","first-page":"57","article-title":"A patient with multiple IRIS","volume":"28","author":"Asselman V","year":"2007","unstructured":"Asselman V, Meintjes G. A patient with multiple IRIS. South African Journal of HIV Medicine. 2007;28:57-60.","journal-title":"South African Journal of HIV Medicine"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-024-10262-x"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-S4-P43"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S534912"},{"key":"e_1_3_7_9_2","first-page":"1793","article-title":"Opportunistic Infections in a Patient with Newly Diagnosed HIV","volume":"9","author":"Riley S","year":"2024","unstructured":"Riley S, Dey D, Sowinski A, Suh JS, Philip S, et al. Opportunistic Infections in a Patient with Newly Diagnosed HIV. Ann Case Report. 2024;9:1793.","journal-title":"Ann Case Report"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.riam.2015.09.001"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mmcr.2016.12.005"},{"issue":"5","key":"e_1_3_7_12_2","first-page":"e202310293","article-title":"Hemophagocytic lymphohistiocytosis in a child with human immunodeficiency virus in the setting of opportunistic viral co-infections","volume":"122","author":"Potanski R","year":"2024","unstructured":"Potanski R, Barsante L, Garreta MC, Lisanti C, Rojas S, de Mena A. Hemophagocytic lymphohistiocytosis in a child with human immunodeficiency virus in the setting of opportunistic viral co-infections. Arch Argent Pediatr. 2024;122(5):e202310293.","journal-title":"Arch Argent Pediatr"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mmcr.2014.05.001"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac513"}],"container-title":["Journal of the International Association of Providers of AIDS Care (JIAPAC)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582261488586","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259582261488586","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259582261488586","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T08:18:45Z","timestamp":1789028325000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259582261488586"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":13,"alternative-id":["10.1177\/23259582261488586"],"URL":"https:\/\/doi.org\/10.1177\/23259582261488586","relation":{},"ISSN":["2325-9582","2325-9582"],"issn-type":[{"value":"2325-9582","type":"print"},{"value":"2325-9582","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"23259582261488586"}}